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.
Manuscripts that are Published Ahead of Print have been peer reviewed and accepted for publication by the Editorial Board of the West Indian Medical Journal. They may appear in their original format and may not be copy edited or formatted in the style guide of this Journal. While accepted manuscripts are not yet assigned a volume, issue or page numbers, they can be cited using the DOI and date of e-publication. See our Instructions for Authors on how to properly cite manuscripts at this stage. The contents of the manuscript may change before it is published in its final form. Manuscripts in this section will be removed once they have been issued to a volume and issue, but will still retain the DOI and date of e-publication.