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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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