Background
Methods
Study design and participants
Measurements
Data analysis
Results
Background characteristics
Number | Percent | |
---|---|---|
Socio-demographic characteristics | ||
Male | 423 | 93.8 |
Age (mean: 32.91, sd: 10.40) | ||
18– | 105 | 23.3 |
25– | 185 | 41.0 |
35–80 | 161 | 35.7 |
Han ethnicity | 422 | 93.6 |
Education level | ||
Junior high or below | 128 | 28.4 |
Senior high school | 142 | 31.5 |
College or above | 181 | 40.1 |
Current marital status | ||
Single | 270 | 59.9 |
Married or cohabitation | 123 | 27.3 |
Others (Married separation/Divorce/Others) | 58 | 12.9 |
Having health insurance | 291 | 64.5 |
Origin | ||
Local (Guangzhou) | 117 | 26.1 |
Other places of Guangdong Province | 107 | 23.8 |
Other Provinces | 225 | 50.1 |
HIV-related characteristics | ||
Duration of HIV infection (months since HIV diagnosis) | ||
<1 | 237 | 52.5 |
1–12 | 78 | 17.3 |
>12 | 136 | 30.2 |
Route of HIV infection | ||
Heterosexual behaviour | 104 | 23.1 |
Homosexual behaviour | 328 | 72.7 |
Injecting drug use/uncertain | 19 | 4.2 |
Infection status of current spouse/regular sex partners | ||
Negative | 57 | 12.6 |
Positive | 52 | 11.5 |
Don’t know | 150 | 33.3 |
Without partner | 192 | 42.6 |
Most recent CD4 counts | ||
<=350 | 243 | 53.9 |
>350 | 208 | 46.1 |
Ever had AIDS-related clinical symptoms | ||
No | 367 | 81.4 |
Yes | 84 | 18.6 |
Psycho-social status | ||
Depression (mean: 7.76, sd: 5.84) | ||
Normal (0–4) | 153 | 33.9 |
Mild (5–9) | 159 | 35.3 |
Moderate-severe (10–27) | 139 | 30.8 |
Psycho-social status | ||
Anxiety (5.63, 4.99) | ||
Normal (0–4) | 213 | 47.2 |
Mild (5–9) | 158 | 35.0 |
Moderate-severe (10–21) | 80 | 17.7 |
Perceived stigma (mean: 31.56, sd: 6.81) | ||
Social support (mean: 57.18, sd: 14.16) | ||
Healthcare workers’ recommendations to initiate ART | ||
From physicians at CHCs | ||
Weak recommendation | 94 | 20.8 |
Strong recommendation | 189 | 41.9 |
Not applicable | 168 | 37.3 |
From physicians at the CDC | ||
Weak recommendation | 67 | 14.9 |
Strong recommendation | 351 | 77.8 |
Not applicable | 33 | 7.3 |
From healthcare workers at NGOs | ||
Weak recommendation | 101 | 22.4 |
Strong recommendation | 90 | 20.0 |
Not applicable | 260 | 57.6 |
Psycho-social status and healthcare workers’ recommendations to initiate ART
Intention to initiate ART and associated background factors
% | Univariate | Multivariate | |||
---|---|---|---|---|---|
ORu | 95% CI | ORm | 95% CI | ||
Socio-demographic characteristics | |||||
Male | 69.3 | 1.69 | (0.78,3.67) | N.S. | |
Age | N.S. | ||||
18– | 70.5 | 1.00 | |||
25– | 66.5 | 0.83 | (0.50,1.40) | ||
35–80 | 69.6 | 0.96 | (0.56,1.64) | ||
Han ethnicity | 69.0 | 1.36 | (0.62,2.96) | N.S. | |
Education level | N.S. | ||||
Junior high or below | 68.0 | 1.00 | |||
Senior high school | 62.7 | 0.79 | (0.48,1.31) | ||
College or above | 73.5 | 1.31 | (0.80,2.15) | ||
Current marital status | |||||
Single | 65.6 | 1.00 | N.S. | ||
Married or cohabitation | 74.0 | 1.49 | (0.93,2.40)+ | ||
Others | 70.7 | 1.27 | (0.68,2.35) | ||
Having health insurance | 71.1 | 1.41 | (0.93,2.13) | N.S. | |
Origin | N.S. | ||||
Local (Guangzhou) | 66.7 | 1.00 | |||
Other places of Guangdong Province | 68.2 | 1.07 | (0.61,1.88) | ||
Other Provinces | 69.8 | 1.15 | (0.72,1.86) | ||
HIV-related variables | |||||
Duration of HIV infection (months since HIV diagnosis) | |||||
<1 | 83.5 | 1.00 | 1.00 | ||
1–12 | 66.7 |
0.39
|
(0.22,0.71)
**
|
0.49
|
(0.27,0.91)
*
|
>12 | 43.4 |
0.15
|
(0.09,0.25)
***
|
0.19
|
(0.11,0.31)
***
|
Route of HIV infection | |||||
Heterosexual behaviour | 70.2 | 1.00 | 1.00 | ||
Homosexual behaviour | 69.8 | 0.98 | (0.61,1.59) | 0.92 | (0.53,1.59) |
Injecting drug use/uncertain | 36.8 |
0.25
|
(0.09,0.69)
**
|
0.16
|
(0.05,0.52)
**
|
Infection status of current spouse/regular sex partners | |||||
Negative | 78.9 | 1.00 | 1.00 | ||
Positive | 63.5 | 0.46 | (0.20,1.09)+ |
0.31
|
(0.12,0.80)
*
|
Don’t know | 76.7 | 0.88 | (0.42,1.84) | 0.62 | (0.27,1.41) |
Without partner | 60.4 |
0.41
|
(0.20,0.82)
*
|
0.32
|
(0.14,0.70)
**
|
Most recent CD4 counts | |||||
<=350 | 77.0 | 1.00 | 1.00 | ||
>350 | 58.7 |
0.43
|
(0.28,0.64)
***
|
0.58
|
(0.37,0.93)
*
|
Ever had AIDS-related clinical symptoms | N.S. | ||||
No | 67.3 | 1.00 | |||
Yes | 73.8 | 1.37 | (0.80,2.33) |
Associations between psycho-social factors, healthcare workers’ recommendations and ART intention
Univariate | Multivariate | ||||
---|---|---|---|---|---|
% | ORu | 95% CI | ORa | 95% CI | |
Psycho-social status | |||||
Depression | |||||
Normal (0–4) | 57.5 | 1.00 | 1.00 | ||
Mild (5–9) | 67.9 | 1.56 | (0.99,2.48)+ | 1.58 | (0.94,2.66)+ |
Moderate-severe (10–27) | 81.3 |
3.21
|
(1.88,5.47)
***
|
2.85
|
(1.57,5.16)
***
|
Anxiety | |||||
Normal (0–4) | 57.3 | 1.00 | 1.00 | ||
Mild (5–9) | 78.5 |
2.72
|
(1.71,4.34)
***
|
2.50
|
(1.49,4.18)
***
|
Moderate-severe (10–21) | 78.8 |
2.76
|
(1.52,5.04)
***
|
2.29
|
(1.17,4.45)
*
|
Perceived stigma | 1.00 | (0.97,1.03) | 1.00 | (0.97,1.03) | |
Social support | 1.01 | (0.99,1.03) | 1.02 | (1.00,1.03)+ | |
Healthcare workers’ recommendations to initiate ART | |||||
From physicians at CHCs | |||||
Weak recommendation | 58.5 | 1.00 | 1.00 | ||
Strong recommendation | 58.2 | 0.99 | (0.6,1.63) | 1.21 | (0.69,2.11) |
Not applicable | 85.7 |
4.26
|
(2.35,7.72)
***
|
2.94
|
(1.53,5.66)
***
|
From physicians at the CDC | |||||
Weak recommendation | 40.3 | 1.00 | 1.00 | ||
Strong recommendation | 76.1 |
4.71
|
(2.73,8.13)
***
|
4.77
|
(2.51,9.05)
***
|
Not applicable | 45.5 | 1.24 | (0.53,2.86) | 1.26 | (0.48,3.33) |
From healthcare workers at NGOs | |||||
Weak recommendation | 46.5 | 1.00 | 1.00 | ||
Strong recommendation | 80 |
4.60
|
(2.40,8.78)
***
|
4.89
|
(2.37,10.08)
***
|
Not applicable | 73.1 |
3.12
|
(1.94,5.03)
***
|
2.78
|
(1.60,4.84)
***
|
Hierarchical logistic regression analyses
Model 1 | Model 2 | Model 3 | |
---|---|---|---|
Background | |||
Duration of HIV infection (months since HIV diagnosis) | |||
<1 | 1.00 | 1.00 | 1.00 |
1–12 |
0.49 (0.27,0.91)
*
| 0.54 (0.29,1.02)+ | 0.79 (0.40,1.57) |
>12 |
0.19 (0.11,0.31)
***
|
0.21 (0.12,0.35)
***
|
0.30 (0.16,0.55)
***
|
Route of HIV infection | |||
Heterosexual behaviour | 1.00 | ||
Homosexual behaviour | 0.92 (0.53,1.59) | 0.95 (0.54,1.66) | 0.79 (0.43,1.46) |
Injecting drug use/uncertain |
0.16 (0.05,0.52)
**
|
0.16 (0.05,0.54)
**
|
0.18 (0.05,0.62)
**
|
Infection status of current spouse/regular sex partners | |||
Negative | 1.00 | 1.00 | 1.00 |
Positive |
0.31 (0.12,0.80)
*
|
0.32 (0.12,0.85)
*
|
0.21 (0.07,0.60)
**
|
Don’t know | 0.62 (0.27,1.41) | 0.65 (0.28,1.49) | 0.60 (0.25,1.42) |
Without partner |
0.32 (0.14,0.70)
**
|
0.31 (0.14,0.70)
**
|
0.23 (0.10,0.54)
**
|
Most recent CD4 counts | |||
<=350 | 1.00 | 1.00 | 1.00 |
>350 |
0.58 (0.37,0.93)
*
|
0.60 (0.37,0.96)
*
| 0.62 (0.37,1.03)+ |
Psycho-social status | |||
Anxiety | N.A. | ||
Normal (0–4) | 1.00 | 1.00 | |
Mild (5–9) |
2.50 (1.49,4.18)
***
|
2.65 (1.52,4.62)
***
| |
Moderate-severe (10–21) |
2.29 (1.17,4.45)
*
|
2.44 (1.19,4.98)
*
| |
Healthcare workers’ recommendations to initiate ART | |||
From physicians at CHCs | N.A. | N.A. | |
Weak recommendation | 1.00 | ||
Strong recommendation | 0.53 (0.26,1.11)+ | ||
Not applicable | 1.19 (0.53,2.71) | ||
From physicians at the CDC | N.A. | N.A. | |
Weak recommendation | |||
Strong recommendation |
3.67 (1.62,8.33)
**
| ||
Not applicable | 1.03 (0.31,3.44) | ||
From healthcare workers at NGOs | N.A. | N.A. | |
Weak recommendation | |||
Strong recommendation |
3.67 (1.58,8.52)
**
| ||
Not applicable | 2.00 (1.00,4.02)+ | ||
-2LL(d.f.) | 473.043(8)*** | 458.218(10) | 395.715(17) |
∆-2LL(d.f.) comparison with Model 1
| N.A. | −14.825*** (2) | N.A. |
∆-2LL(d.f.) comparison with Model 2
| N.A. | N.A. | −47.406*** (6) |