Delayed Entry into Health Care for Women with HIV Disease

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Abstract
The primary objective was to evaluate factors that might influence delayed entry into health care for women with HIV. Implications of time of diagnosis for early medical intervention was a focused aspect. Structured clinical interviews were conducted with HIV-positive women (n = 48); these data were supplemented by medical chart reviews. Delayed entry into health care was operationalized as a difference of more than 3 months between diagnosis and entry into care. Measures of race, social class, risk behavior circumstances of HIV testing, and health status were included. Of women, 58% delayed entry into care following an HIV diagnosis. Upon entry into health care, 65% of women were symptomatic and 40% were severely immunocompromised (CD4 cells/mm3 < 200). Results from the logistic regression indicated that those who learned their HIV status prenatally were four times more likely to delay entry into care compared to those who self-referred for HIV testing, even after controlling for symptom status. HIV diagnosis is not enough to ensure that women with HIV will get adequate and timely health care. Counseling and testing recommendations should highlight the intrinsic value of early diagnosis.
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