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Patients aged 30-49 years were at increased risk of "delayed presentation to care" and presentation to care with advanced HIV disease compared to patients aged <30 years, but patients aged >50 years were not.
Risk factors for "delayed presentation to care" and presentation to care with advanced HIV disease were: age 30-49 years, HIV transmission through heterosexual contact or injection drug use, enrolment in the study between 1997 and 1999, and follow-up in Brussels.
Moreover, within patients with advanced HIV disease we determined the frequency of "late testing" (i.e.; HIV diagnosis ≤6 months before initial presentation to care) and "delayed presentation to care" (i.e.; HIV diagnosis >6 months before initial presentation to care).
Currently, ART programs do not monitor pre-ART attrition, but systematically providing attention on reducing pre-ART attrition may prevent late presentations to care.
Finally, we assessed the potential risk factors associated with "delayed presentation to care"/ late testing" and presentation to care with advanced HIV disease.
Although most of our results are consistent with previous studies, some risk factors for "delayed presentation to care" and "late testing" may depend on geography: patients in Brussels were more likely to be diagnosed early and delay presentation care compared to patients in Northern France.
Median time from HIV diagnosis to initial presentation to HIV care in the "delayed presentation to care" group was 55 months (IQR, 23-88).
In contrast, the rate of "delayed presentation to care" did differ significantly between countries: "delayed presentation to care" was twice as frequent in Brussels than in Northern France (Table 3).
We assessed the factors associated with "late testing" and "delayed presentation to care" and compared them to the factors associated with "earlier presentation," defined as initiation of HIV care at CD4 counts >200/mm3 and no AIDS.
We show that the risk factors for "delayed presentation to care" and "late testing" among patients who present with advanced HIV disease are different.
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