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Risk Factors for Delayed Access to Specialized Care in French Guiana

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  • Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana; COREVIH Guyane, CH de Cayenne, Cayenne, French Guiana; Service de Médecine, INSERM CIE 802, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana; Hôpital de Jour, CH de Cayenne, Cayenne, French Guiana; Service Dermatologie, CH de Cayenne, Cayenne, French Guiana
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The variables influencing the interval between diagnosis and effective access to specialized care were studied in a cohort of 2,661 human immunodeficiency virus (HIV)-positive patients in French Guiana between 1992 and 2008. Patients with a subsequent follow-up interruption were significantly more likely to have a delayed first consultation after the HIV diagnosis. Ordinal logistic regression showed that younger persons, women, and French citizens were independently associated with greater delays between the HIV diagnosis and the first specialized consultation. However, persons with acquired immunodeficiency syndrome (AIDS) were less likely to have a delay between the HIV diagnosis and the first specialized consultation. Focusing on the link between the private sector and specialized health care may shorten delays and improve care and follow-up.

Author Notes

*Address correspondence to Mathieu Nacher, Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane, INSERM CIE 802, Centre Hospitalier de Cayenne and COREVIH Guyane, CH de Cayenne, Cayenne, French Guiana. E-mail: mathieu.nacher@ch-cayenne.fr

Authors' addresses: Mathieu Nacher, Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane, INSERM CIE 802, Centre Hospitalier de Cayenne and COREVIH Guyane, CH de Cayenne, E-mail: mathieu.nacher@ch-cayenne.fr. Leila Adriouch, COREVIH Guyane, CH de Cayenne, E-mail: adriouchleila@yahoo.fr. Antoine Adenis, Matthieu Hanf, Astrid Van Melle, and Marie Claire Parriault, Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane, INSERM CIE 802, Centre Hospitalier de Cayenne, E-mails: antoine.adenis@gmail.com. matthieu.hanf@ch-cayenne.fr, astrid.van-melle@ch-cayenne.fr, and marie-claire.parriault@ch-cayenne.fr. Mélanie Calvez, Hôpital de Jour, CH de Cayenne, E-mail: mcalvez@yahoo.fr. Julie Dufour, Emmanuelle Papot, and Pierre Couppié, Service Dermatologie, CH de Cayenne, E-mails: julie.dufour@ch-cayenne.fr, emmanuelle.papot@ch-cayenne.fr, and couppie.pierre@voila.fr. Vincent Vantilcke, Service de Médecine, Centre Hospitalier de l'Ouest Guyanais, E-mail: v.vantilcke@ch-ouestguyane.fr.

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