Pusat Pengajian Sains Perubatan - Tesis

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    Factors associated with late presentation of HIV cases in Pulau Pinang, 2017 - 2021
    (2023-06)
    Ibrahim, Ahmad Syahid
    Background: HIV infection remains a significant public health problem, with the World Health Organization reporting approximately 37.7 million people living with the disease globally and 81,000 in Malaysia in 2021. Despite the national goal to end AIDS epidemic by 2030, the incidence of new HIV cases in Malaysia, has remained static since 2010, in part due to late presentation of the cases where in 2021, 68% of new HIV cases presented late. Objective: This study aimed to describe the trend and characteristics of late presenters of HIV cases in Pulau Pinang from 2017 – 2021 and to identify the factors associated with late presentation of HIV cases in this region over this timeframe. Methodology: This was a cross-sectional study using secondary data, year 2017 until year 2021. The study was conducted from March to June 2023. Relevant data were extracted from National AIDS Registry and the Lampiran_13a_Daftar PLHIV Penang State Health Department. The data were collected using proforma and were analysed using SPSS software version 27. The data were analysed using descriptive analysis, simple and multiple logistic regression. Results: A total of 1196 sample were included in the study in which the proportion of late presentation was 62.2%. Majority of cases with late presentation are those age above 50 (80.4%), Chinese (65.5%), unemployed (60.6%), people who injected drugs (68.2%), Timur Laut District (64.4%), Hepatitis C coinfection (72.5%) and Tuberculosis coinfection (81.4%). Trend in Pulau Pinang showed an overall rising of late presentation proportion ranging from 57.6% to 64.4%. The associated factors for late presentation were individuals aged 30-49 (AOR 1.91, 95% CI: 1.45, 2.51) and age 50 and above (AOR 4.0, 95% CI: 2.44, 6.55), Chinese (AOR 2.06, 95% CI: 1.35, 3.13) and Malay (AOR 2.45, 95% CI: 1.64, 3.65), unemployed (AOR 1.40, 95% CI: 1.00, 1.95) and Tuberculosis coinfection (AOR 2.64, 95% CI: 1.69, 4.14). Conclusion: Age, ethnicity, employment status and Tuberculosis coinfection significantly were the factors associated with HIV late presentation in Pulau Pinang. Future research should explore the reasons behind the observed disparities in late presentation among different age group, races, employment status, Tuberculosis coinfection and develop strategies to address these issues.