What's pregnancy got to do with it? Late presentation to @entity645 / XXXX services in Northeastern Brazil.

@entity1 @entity404 @entity645 @entity791 @entity18451
Despite the known benefits of early treatment initiation for individual morbidity and mortality, as well as for reducing the risk of transmission, late presentation (LP) to @entity645 / @entity791 services remains a major concern in many countries. There is little information on LP from middle- and low-income countries and studies that do evaluate LP commonly disaggregate data by sex. It is rare, however, for researchers to further disaggregate the data by pregnancy status so it remains unclear if pregnancy status modifies the effects associated with sex. The study was conducted at the only State Reference Center for @entity645 / @entity791 in Salvador, Brazil's third largest city. LP was defined as a @entity1 accessing services with a @entity404 < 350 cells/mm(3). Data were abstracted from the electronic medical records of 1421 @entity1 presenting between 2007 and 2009. @entity404 counts and viral load (VL) information was validated with data from the National @entity404 /VL Database. Descriptive and bivariate statistics were conducted to inform the multivariate analysis. Adjusted prevalence ratios (APR) were estimated using generalized linear models due to the high frequency of the outcome. Half of the sample (52.5%; n = 621) was classified as LP. Compared to the prevalence among pregnant @entity1 (21.1%), the prevalence of LP was more than twice as high among non-pregnant @entity1 (56.0%) and among @entity1 (55.4%). The multivariate analysis demonstrated no statistical difference between @entity1 and nonpregnant @entity1 ( @entity18451 .04; 95%CI 0.92-1.19), but the APR of LP for nonpregnant @entity1 was 53% less than @entity1 (APR 0.47; 95%CI 0.33-0.68). These results highlight the importance of analyzing data disaggregated not only by sex but also by pregnancy status to accurately identify the risk factors associated with LP so that programs and policies can effectively and efficiently address LP in Brazil and beyond.
