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Table 2 Access to HIV testing and healthcare pre-diagnosis among Dutch aMASE-study participants (n = 247), 2013–2015

From: Disparities in access to and use of HIV-related health services in the Netherlands by migrant status and sexual orientation: a cross-sectional study among people recently diagnosed with HIV infection

  Total Migrant MSM Non-migrant MSM Migrant heterosexual men Non-migrant heterosexual men Migrant women  
(n = 247) (n = 77) (n = 115) (n = 21) (n = 14) (n = 20)  
n % n % n % n % n % n % p-valuea
Age (years) at HIV diagnosis (Median, IQR)b 39 31–47 34 26–44 41 33–49 42 38–47 38 32–50 37 30–46 0.006
Years since HIV diagnosis (Median, IQR) 2 1–4 2 1–3 3 1–4 2 1–3 3 1–4 2 1–4 0.046
Location of HIV diagnosis              < 0.001c
 Sexual health clinic / HIV testing clinic 103/238 43.3 42/70 60.0 52/115 45.2 2/19 10.5 3/14 21.4 4/20 20.0  
 Hospital 66/238 27.7 13/70 18.6 25/115 21.7 10/19 52.6 9/14 64.3 9/20 45.0  
 GP 57/238 23.9 12/70 17.1 34/115 29.6 4/19 21.1 1/14 7.1 6/20 30.0  
 Otherd 12/238 5.0 3/70 4.3 4/115 3.5 3/19 15.8 1/14 7.1 1/20 5.0  
Reason for HIV teste
 It was part of a routine health checkup 89/245 36.3 30/77 39.0 51/114 44.7 4/21 19.1 3/13 23.1 1/20 5.0  
 A doctor advised me to test due to health problems 86/245 35.1 18/77 23.4 36/114 31.6 13/21 61.9 5/13 38.5 14/20 70.0  
 I felt I was at risk 48/245 19.6 22/77 28.6 21/114 18.4 3/21 14.3 1/13 7.7 1/20 5.0  
 I had sexual contact with someone I knew/thought had HIV 37/245 15.1 19/77 24.7 13/114 11.4 0/21 0.0 3/13 23.1 2/20 10.0  
 Otherf 16/245 6.5 3/77 3.9 5/114 4.4 3/21 14.3 2/13 15.4 3/20 15.0  
Years between migration to the Netherlands and HIV diagnosis 8 2–21 6 1–22 NA 9 4–15 NA 10 2–19 0.911
Country of HIV diagnosis              0.696
 The Netherlands 109/118 92.4 70/77 90.9 NA 19/21 90.5 NA 20/20 100.0  
 Country of birth 7/118 5.9 5/77 6.5 2/21 9.5 0/20 0.0  
 Other country 2/118 1.7 2/77 2.6 0/21 0.0 0/20 0.0  
CD4 cell count (cells/mm3) at HIV diagnosis (Median, IQR)g 400 220–570 430 280–580 475 320–647 125 40–230 225 20–570 260 50–430 < 0.001
Late-stage HIV infection at HIV diagnosis (AIDS or a CD4 count < 350 cells/mm3) 101/239 42.3 26/74 35.1 37/112 33.0 17/20 85.0 10/14 71.4 11/19 57.9  
Ever had a negative HIV test before HIV diagnosis 192/247 77.7 69/77 89.6 96/115 83.5 11/21 52.4 4/14 28.6 12/20 60.0  
Years between previous negative HIV test and HIV diagnosis (Median, IQR)h,i 2 1–4 2 1–4 1 0–3 6 1–9 6 2–11 5 3–12 0.002
Country of previous HIV negative testi
 The Netherlands 52/86 60.5 41/66 62.1 NA 5/10 50.0 NA 6/10 60.0  
 Another country 34/86 39.5 25/66 37.9 5/10 50.0 4/10 40.0  
Registered at a GP in the Netherlands 241/247 97.6 73/77 94.8 115/115 100.0 19/21 90.5 14/14 100.0 20/20 100.0  
Healthcare usage in the Netherlands 2 years before HIV diagnosisj 202/217 93.1 52/56 92.9 110/115 95.7 15/17 88.2 12/14 85.7 13/15 86.7  
No HIV testing discussed during healthcare attendance in the 2 years before HIV diagnosisk 116/197 58.9 26/51 51.0 58/107 54.2 11/15 73.3 11/11 100.0 10/13 76.9  
Experienced difficulties accessing healthcare in the Netherlands 26/246 10.6 16/77 20.8 3/115 2.6 3/20 15.0 0/14 0.0 4/20 20.0  
Type of difficulties experienced in accessing healthcare in the Netherlandse,l
 I am still unsure of my rights to access healthcare 10/26 38.5 5/16 31.3 0/3 0.0 3/3 100.0 0/0 0.0 2/4 50.0  
 Clinic opening hours are inconvenient 5/26 19.2 4/16 25.0 1/3 33.3 0/3 0.0 0/0 0.0 0/4 0.0  
 There are long waiting times for an appointment 6/26 23.1 4/16 25.0 1/3 33.3 0/3 0.0 0/0 0.0 1/4 25.0  
 I have difficulty communicating with staff because of language differences 8/26 30.8 3/16 18.8 0/3 0.0 2/3 66.7 0/0 0.0 3/4 75.0  
 Other 13/26 50.0 8/16 50.0 3/3 100.0 1/3 33.3 0/0 0.0 1/4 25.0  
Ever heard of post-exposure prophylaxis (PEP) 162/245 66.1 46/77 59.7 101/113 89.4 3/21 14.3 8/14 57.1 4/20 20.0  
  1. MSM men who have sex with men, IQR interquartile range, GP General Practitioner
  2. a only p-values are presented for variables not included in Fig. 2
  3. b 3 missings
  4. c p-value calculated without the other category
  5. d Other includes: antenatal care (n = 3), refugee center (n = 3), fertility clinic (n = 1), dentist (n = 1), self-test (n = 1), medical examination (n = 1), private clinic (n = 1), unknown (n = 1)
  6. e Total number and percentage exceeds 100% because more than one answer could be given
  7. f Other reasons are for example: pregnancy, test done without permission of participant, relationship, sexual assault
  8. g 8 missings
  9. h 56 missings
  10. i Only participants were included who had a previous negative HIV test before diagnosis
  11. j Only participants were included who lived in the Netherlands for 2 years or more and who were diagnosed with HIV in the Netherlands
  12. k Only participants were included who lived in the Netherlands for 2 years or more, who were diagnosed with HIV in the Netherlands and who had used healthcare in the Netherlands in the previous 2 years before HIV diagnosis
  13. l Only participants were included who experienced difficulties accessing healthcare in the Netherlands
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BMC Infectious Diseases

ISSN: 1471-2334

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