{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:52:18Z","timestamp":1793746338838,"version":"4.6.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["AIDS Res Ther"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In 2007\u20132012 the Mexican government launched the National HIV program and there was a major change in HIV policies implemented in 2013\u20132018, when efforts focused on prevention, increase in early diagnosis and timely treatment. Still, late HIV diagnosis is a major concern in Mexico due to its association with the development of AIDS development and mortality. Thus, the objectives of this study were to identify the determinants of late HIV diagnosis (i.e. CD4 count less than 200 cells\/mm<jats:sup>3<\/jats:sup>) in Mexico from 2008 to 2017 and to evaluate the impact of the 2013\u20132017 National HIV program.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using patient level data from the SALVAR database, which includes 64% of the population receiving HIV care in Mexico, an adjusted logistic model was conducted. Main study outcomes were HIV late diagnosis which was defined as CD4 count less than 200 cells\/mm<jats:sup>3<\/jats:sup> at diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study included 106,830 individuals newly diagnosed with HIV and treated in Mexican public health facilities between 2008 and 2017 (mean age: 33\u00a0years old, 80% male). HIV late diagnosis decreased from 45 to 43% (P\u2009&lt;\u20090.001) between 2008 and 2012 and 2013\u20132017 (i.e. before and after the implementation of the 2013\u20132017 policy). Multivariable logistic regressions indicated that being diagnosed between 2013 and 2017 (odds ratio [OR]\u2009=\u20090.96 [95% Confidence interval [CI] [0.93, 0.98]) or in health facilities specialized in HIV care (OR\u2009=\u20090.64 [95% CI 0.60, 0.69]) was associated with early diagnosis. Being male, older than 29\u00a0years old, diagnosed in Central East, the South region of Mexico or in high-marginalized locality increased the odds of a late diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The results of this study indicate that the 2013\u20132017 National HIV program in Mexico has been marginally successful in decreasing the proportion of individuals with late HIV diagnosis in Mexico. We identified several predictors of late diagnosis which could help establishing health policies. The main determinants for late diagnosis were being male, older than 29\u00a0years old, and being diagnosed in a Hospital or National Institute.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12981-021-00409-0","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T11:02:37Z","timestamp":1636801357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Patient characteristics and determinants of CD4 at diagnosis of HIV in Mexico from 2008 to 2017: a 10-year population-based study"],"prefix":"10.1186","volume":"18","author":[{"given":"Amilcar","family":"Azamar-Alonso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio A.","family":"Bautista-Arredondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Smaill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Eric","family":"Tarride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"409_CR1","unstructured":"UNAIDS. 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Analyzed data is from an anonymized database. Authors have not contact with participants or their sensitive information such as name or address or any other data that could identified them. Authors received consent for the use of the SALVAR data set.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"We used secondary data. Authors have not contact with participants or their specific information such as name or address. Authors received consent for the publication of results derived from the SALVAR data set.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This study is part of AA PhD thesis. AA declares that he works full-time for Gilead Sciences Mexico S. de R.L. de C.V. AA declares that he did not receive any financial support from the firm to perform the analysis. The information contained in all data set was not used for the firm\u2019s benefit, promotion or strategies. The analysis we are presenting do not intend to promote or recommend any of the products mentioned in the paper. The other authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}