Late HIV Diagnosis and Delayed Antiretroviral Therapy Prescription in Routine Care Within a Mexican Social-Security Network
Juan Alberto Hidalgo-López, José Manuel López-Cruz, Rafael López-MartínezBackground
Late HIV diagnosis and delayed antiretroviral therapy (ART) prescription hinder care. We estimated frequencies and patient-level associations.
Methods
We retrospectively analyzed 137 records from a family-medicine source in southeastern Mexico (2021-2023). Outcomes were late diagnosis (CD4 <350 cells/µL or WHO/PAHO stage III-IV) and delayed first ART prescription (>30 days after confirmed diagnosis). Modified Poisson regression estimated adjusted prevalence ratios.
Results
Late diagnosis was classifiable in 129 records and present in 104 (80.6%; 95% CI, 73.0%-86.5%). Prescription timing was available in 120; 86 (71.7%; 95% CI, 63.0%-79.0%) exceeded 30 days. Medium and low education each had a 40% higher adjusted prevalence of late diagnosis than high education. No covariate was associated with delayed prescription.
Conclusions
Both outcomes were common. Education was associated with late diagnosis; no measured patient-level variable was independently associated with prescription delay. Care-process determinants require prospective measurement.