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Lisa S BURCH, Natasha OAKES-MONGER, Colette J SMITH, Fiona C LAMPE, Rob TSINTAS, Clinton CHALONER, Anderw N PHILLIPS, Margaret A JOHNSON Research Department.

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Presentation on theme: "Lisa S BURCH, Natasha OAKES-MONGER, Colette J SMITH, Fiona C LAMPE, Rob TSINTAS, Clinton CHALONER, Anderw N PHILLIPS, Margaret A JOHNSON Research Department."— Presentation transcript:

1 Lisa S BURCH, Natasha OAKES-MONGER, Colette J SMITH, Fiona C LAMPE, Rob TSINTAS, Clinton CHALONER, Anderw N PHILLIPS, Margaret A JOHNSON Research Department of infection and population health,, UCL, Rowland Hill Street, London, UK, NW3 2PF, and Royal Free London Foundation Hospital, Department of Thoracic Medicine, Ian Charleson Day Centre, Pond Street,m London, NW2 1QG. Correspondance to: lisa.burch.13@ucl.ac.uk Socio-economic factors and late diagnosis of HIV in 2011-2013 in the Royal Free cohort Lake diagnosis of HIV in the UK continues to be a major problem, with 47% diagnosed late (CD4<350) and 26% very late 1 (CD4<200) in 2012. In addition to increased risk of disease progression, late diagnosis may increase the risk of onwards HIV transmission. Little is known about the association between late diagnosis and socio-economic factors such as housing, education and employment. We investigated the predictors of late diagnosis amongst newly diagnosed individuals attending the Royal Free Hospital, London, UK between April 2011 and May 2013. Percentages with late diagnosis were calculated and presented in a table. Associations between socio-economic factors and late diagnosis were assessed by logistic regression, p-values were calculated using a Wald test and the 95% CIs, calculated as estimate ± 1.96*standard error, were also presented. Logistic models were adjusted for gender, mode of acquisition and age, but not for other markers of SES bcause of co-linearity and because of a lack of statistical power. IMD, based on postcode was calculated for all English postcodes. Data were collected via a patient registration form including information on presentation, risk behaviour, medical history and socio-economic characteristics. Late diagnosis was defined as a CD4<350 measured within 3 months of diagnosis. There were 203 newly-diagnosed individuals; 92 (45%) were diagnosed with CD4<350 (29% with CD4<200). Median CD4 at diagnosis was 373 (range 3 – 1672). Late diagnosis was seen more frequently amongst (Table 1) females or heterosexual males, those over 40 years of age, black Africans, parents, married individuals, those who are not privately renting or not owner-occupiers, those who are not university educated, those who did not self-prompt for an HIV test, those who reported it likely they acquired HIV outside of the UK, tose who had never had an HIV test before, and there was no evidence of an association with employment or IMD. Gender/ mode of acquisition, age, ethnicity, children, HIV test prompt and UK or non-UK infection significantly affected late diagnosis, until adjusted for gender/mode of acquisition and age, when only test seeking behaviour remained significant (Table 1). Results were consistant when adjusted for gender/mode of acquisition. TABLE 2: LATE DIAGNOSIS Background Methods Results Conclusion TABLE “: PROPORTIONS DIAGNOSED WITH CD4<350 ORP Gender/modeMSM10.0007 of acquisitionMSW3.3 Woman3.0 Age<30 years10.0806 30-40 years0.91 40-50 years1.52 >50 years1.76 EthnicityWhite10.2346 Black African1.9338 Other0.9973 ChildrenNo10.5696 Yes1.5 Unknown1.2 Married/No10.6151 civilYes1.48 partnershipUnknown1.04 It is encouraging that late diagnosis is not found to be significantly associated with socio-economic status, however, we cannot exclude a modest relationship without a larger study population. Test-seeking behaviour was found to significantly affect late diagnosis, in particular that self- prompting an HIV test is associated with half the odds of being diagnosed late. This suggests that strategies to increase regular HIV testing remain a priority. ORP HousingOwn/private rent10.7283 Council rent/not own home 1.0 EducationUniversity10.4807 Non-university1.21 EmploymentEmployed10.8305 Unemployed0.93 HighNo10.7633 deprivationYes1.11 HIV test prompt by Self10.0852 GP/healthcare professional 2.17 Unknown1.76 Infected inYes10.3215 UKNo1.49 Unknown1.38 JusTRI 12 th December 2015. This is a modified version for teaching purposes. For original poster, (and acknowledgements) see Poster 285, 3rd Joint Conference of the British HIV Association (BHIVA) with the British Association for Sexual Health and HIV (BASHH), Liverpool, UK, 1–4 April 2014 % late Gender/ sexual orientation MSM30.69 MSW61.9 Women58.33 EthnicityWhite37.25 Black African63.64 Other41.3 Age<30 years33.33 30-40 years37.1 40-50 years52.05 >50 years55.26 HousingOwn/private rent42.16 Council rent55.81 Unknown43.1 EducationUniversity37.5 Non-university51.56 Unknown46.67 EmploymentEmployed42.24 Non-employed44.12 Unknown52.83 High deprivation (IMD No45.64 Yes42.59 ChildrenNo34.69 Yes61.4 Unknown47.92 Married/ civil partnership No39.39 Yes58.97 Unknown46.15 HIV test prompted by Self30.86 GP/ HCW56.58 Unknown52.17 Infected in UKYes34.52 No52.94 Unknown52.94


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