A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States
Prompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2017-03-01
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| Series: | Journal of the International Association of Providers of AIDS Care |
| Online Access: | https://doi.org/10.1177/2325957417692679 |
| _version_ | 1828824625767776256 |
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| author | Neela D. Goswami MD, MPH Jonathan Colasanti MD, MPH Jonathan J. Khoubian MD Yijian Huang PhD Wendy S. Armstrong MD Carlos del Rio MD |
| author_facet | Neela D. Goswami MD, MPH Jonathan Colasanti MD, MPH Jonathan J. Khoubian MD Yijian Huang PhD Wendy S. Armstrong MD Carlos del Rio MD |
| author_sort | Neela D. Goswami MD, MPH |
| collection | DOAJ |
| description | Prompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART have been less studied. We reviewed hospitalizations for persons newly diagnosed with AIDS at Grady Memorial Hospital in Atlanta, Georgia in 2011 and 2012. Individual- and system-level variables were collected. Logistic regression models were used to estimate the odds ratios (ORs) for ART initiation prior to discharge. With Georgia Department of Health surveillance data, we estimated time to first clinic visit, ART initiation, and viral suppression. In the study population (n = 81), ART was initiated prior to discharge in 10 (12%) patients. Shorter hospital stay was significantly associated with lack of ART initiation at the time of HIV diagnosis (8 versus 24 days, OR: 1.14, 95% confidence interval: 1.04-1.25). Reducing barriers to ART initiation for newly diagnosed HIV-positive patients with short hospital stays may improve time to viral suppression. |
| first_indexed | 2024-12-12T14:01:09Z |
| format | Article |
| id | doaj.art-a925d225bb0146e6b332e6754d7f30f1 |
| institution | Directory Open Access Journal |
| issn | 2325-9574 2325-9582 |
| language | English |
| last_indexed | 2024-12-12T14:01:09Z |
| publishDate | 2017-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of the International Association of Providers of AIDS Care |
| spelling | doaj.art-a925d225bb0146e6b332e6754d7f30f12022-12-22T00:22:20ZengSAGE PublishingJournal of the International Association of Providers of AIDS Care2325-95742325-95822017-03-011610.1177/2325957417692679A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United StatesNeela D. Goswami MD, MPH0Jonathan Colasanti MD, MPH1Jonathan J. Khoubian MD2Yijian Huang PhD3Wendy S. Armstrong MD4Carlos del Rio MD5 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USAPrompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART have been less studied. We reviewed hospitalizations for persons newly diagnosed with AIDS at Grady Memorial Hospital in Atlanta, Georgia in 2011 and 2012. Individual- and system-level variables were collected. Logistic regression models were used to estimate the odds ratios (ORs) for ART initiation prior to discharge. With Georgia Department of Health surveillance data, we estimated time to first clinic visit, ART initiation, and viral suppression. In the study population (n = 81), ART was initiated prior to discharge in 10 (12%) patients. Shorter hospital stay was significantly associated with lack of ART initiation at the time of HIV diagnosis (8 versus 24 days, OR: 1.14, 95% confidence interval: 1.04-1.25). Reducing barriers to ART initiation for newly diagnosed HIV-positive patients with short hospital stays may improve time to viral suppression.https://doi.org/10.1177/2325957417692679 |
| spellingShingle | Neela D. Goswami MD, MPH Jonathan Colasanti MD, MPH Jonathan J. Khoubian MD Yijian Huang PhD Wendy S. Armstrong MD Carlos del Rio MD A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States Journal of the International Association of Providers of AIDS Care |
| title | A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States |
| title_full | A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States |
| title_fullStr | A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States |
| title_full_unstemmed | A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States |
| title_short | A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States |
| title_sort | minority of patients newly diagnosed with aids are started on antiretroviral therapy at the time of diagnosis in a large public hospital in the southeastern united states |
| url | https://doi.org/10.1177/2325957417692679 |
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