ABSTRACT
Objective: To determine the continuum of HIV care and factors associated with delayed entry and start of cART in Curaçao.
Methods: We analysed linkage to care, starting cART and viral suppression after cART for all 551 individuals who were newly diagnosed with HIV-1 infection in Curaçao between 2000 and 2010.
Results: After diagnosis, 367 (67%) individuals were linked to care, of whom 214 (58%) within 3 months after diagnosis. Being diagnosed before 2005 (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.28-0.57) was independently associated with delayed entry (>3 months). Amongst 267 (48% of the 551) individuals who started cART, 166 (62%) individuals achieved viral suppression six months after starting cART, or 30% of all newly diagnosed. Pregnant women showed shorter time to treatment initiation (relative hazard [RH] 3.40, 95%CI 1.77-6.55) and advanced disease stage at entry was associated with a shorter time (RH 3.0, 95%CI 2.0-4.4).
Conclusion: Although improving over calendar time, individuals newly diagnosed with HIV-1 infection in Curaçao show inefficient entry and retention into care resulting in a low overall proportion of viral suppression.
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