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. 2023 Jan;27(1):303-313.
doi: 10.1007/s10461-022-03764-9. Epub 2022 Aug 2.

Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women

Sarah M Lofgren  1   2 , Sharon Tsui  3 , Nakita Natala  4 , Noeline Nakasujja  5 , Raymond Sebuliba  3 , Jane Francis Ndyetukira  3 , Anita Arinda  3   5 , Vanessa Akinyange  3 , Kathy H Hullsiek  6 , Elizabeth Nalintya  3 , Alisat Sadiq  3 , Katelyn A Pastick  7 , Anna Stadleman  6 , David Meya  3 , David R Boulware  7
Affiliations

Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women

Sarah M Lofgren et al. AIDS Behav. 2023 Jan.

Abstract

Late presentation to HIV care, i.e., presenting with < 200 CD4 cells/mL, is associated with higher mortality and worse outcomes. Despite that, a quarter of people living with HIV in Uganda still present late to care. We surveyed Ugandans living with HIV who enrolled in clinic ≤ 90 days prior. We compared groups who presented 'late' with CD4 < 200 and 'early' with CD4 > 350, stratifying by sex. We found men who presented late had higher externalized stigma than early presenters. Thirty-six percent of the entire cohort were depressed. Social support was stronger in late presenters versus early, although weak overall. Social support was inversely correlated with depression, with social support dropping as depression increased. Interventions to improve clinic privacy, reduce stigma, improve social support, and help women disclose their HIV status to male partners are needed to reduce late presentation to HIV care.

Keywords: HIV care; HIV stigma; Late presentation; Sex differences; Universal test and treat.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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