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In Botswana, where more than half of cancers arise in HIV-infected individuals, we sought to explore predictors of timely oncology care and evaluate the hypothesis that engagement in longitudinal HIV care improves access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Consenting patients presenting for oncology care from October 2010 to September 2014 were interviewed and their records were reviewed. Cox and logistic models were used to examine the effect of HIV and other predictors on time to oncology care and presentation with advanced cancer (stage III or IV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Of the 1,146 patients analyzed, 584 (51%) had HIV and 615 (54%) had advanced cancer. The initial clinic visit occurred a mean of 144 days (median 29, interquartile range 0\u2013185) after symptom onset, but subsequent mean time to oncology care was 406 days (median 160, interquartile range 59\u2013653). HIV status was not significantly associated with time to oncology care (adjusted hazard ratio [aHR] 0.91, 95% confidence interval [CI] 0.79\u20131.06). However, patients who reported using traditional medicine\/healers engaged in oncology care significantly faster (aHR 1.23, 95% CI 1.09\u20131.40) and those with advanced cancer entered care earlier (aHR 1.48, 95% CI 1.30\u20131.70). Factors significantly associated with advanced cancer included income &amp;lt;$50 per month (adjusted odds ratio [aOR] 1.35, 95% CI 1.05\u20131.75), male sex (aOR 1.45, 95% CI 1.12\u20131.87), and pain as the presenting symptom (aOR 1.39, 95% CI 1.03\u20131.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Longitudinal HIV care did not reduce the substantial delay to cancer treatment. Research focused on reducing health system delay through coordination and navigation is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1634\/theoncologist.2015-0387","type":"journal-article","created":{"date-parts":[[2016,4,7]],"date-time":"2016-04-07T01:24:12Z","timestamp":1459992252000},"page":"731-738","source":"Crossref","is-referenced-by-count":29,"title":["Predictors of Timely Access of Oncology Services and Advanced-Stage Cancer in an HIV-Endemic Setting"],"prefix":"10.1093","volume":"21","author":[{"given":"Carolyn A.","family":"Brown","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"},{"name":"Emory Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Suneja","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neo","family":"Tapela","sequence":"additional","affiliation":[{"name":"University of Botswana School of Medicine, Gaborone, Botswana"},{"name":"Department of Oncology, Princess Marina Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Mapes","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malebogo","family":"Pusoentsi","sequence":"additional","affiliation":[{"name":"Ministry of Health Botswana, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mompati","family":"Mmalane","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Hodgeman","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Boyer","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"},{"name":"Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zola","family":"Musimar","sequence":"additional","affiliation":[{"name":"Department of Oncology, Princess Marina Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Ramogola-Masire","sequence":"additional","affiliation":[{"name":"Botswana-UPenn Partnership Health Program, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Memory","family":"Nsingo-Bvochora","sequence":"additional","affiliation":[{"name":"Department of Oncology, Gaborone Private Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukendi","family":"Kayembe","sequence":"additional","affiliation":[{"name":"Anatomic Pathology, National Health Laboratory, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Efstathiou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Lockman","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute, Gaborone, Botswana"},{"name":"Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard T.H. 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