@article{PAR00003588,
  title = {{D}elayed first consultation after diagnosis of {HIV} infection in {C}ameroon},
  author = {{M}arcellin, {F}. and {A}be, {C}. and {L}oubi{\`e}re, {S}. and {B}oyer, {S}. and {B}lanche, {J}. and {K}oulla-{S}hiro, {S}. and {O}ngolo-{Z}ogo, {P}. and {M}oatti, {J}ean-{P}aul and {S}pire, {B}. and {C}arrieri, {M}. {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives: {T}o study the impact of both decentralization of {HIV} care and individual factors on delayed first consultation (>= 6 months) after {HIV} diagnosis in {C}ameroon, in the context of the national antiretroviral treatment scale-up program. {D}esign: {T}he national cross-sectional multicenter survey {EVAL} ({ANRS} 12-116) was conducted from {S}eptember 2006 to {M}arch 2007 in 27 {HIV} centers in {C}ameroon. {M}ethods: {L}ogistic regression was used to characterize patients with delayed first consultation among 3151 {HIV}-infected adults. {R}esults: {F}ifteen percent of patients reported a delay of at least 6 months before their first consultation after {HIV} diagnosis. {I}n the multivariate analysis adjusted for the frequency of visits to the {HIV} center, independent correlates of reporting a delay of at least 6 months before consulting included the characteristics of the {HIV} centers (created before 2005 and located in small or medium-size hospitals) and the following individual patient characteristics: sex and matrimonial status (women living in a couple), the circumstances of the {HIV} diagnosis (test not performed in the hospital providing {HIV} care, test performed during a voluntary screening campaign) and patient's negative perception of antiretroviral treatment toxicity. {C}onclusion: {D}elays before first consultation for {HIV} care in {C}ameroon have been reduced, thanks to the full implementation of the national program of decentralization. {R}esults underline the importance of coordinating diagnosis with treatment activities and the need to develop counseling actions, focusing on the balance between antiretroviral treatment effectiveness and its potential side effects. {C}ounseling should also be part of patients' follow-up after diagnosis during voluntary screening campaigns.},
  keywords = {{A}frica ; delayed access to care ; scale-up},
  booktitle = {},
  journal = {{A}ids},
  volume = {23},
  numero = {8},
  pages = {1015--1019},
  ISSN = {0269-9370},
  year = {2009},
  DOI = {10.1097/{QAD}.0b013e32832a5996},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00003588},
}