Late HIV treatment remains a global public health issue despite significant efforts. To better understand what shapes this issue, we interviewed 36 Vietnamese ART-naive patients who came to HIV treatment in 2017. Half of them had intake CD4 counts fewer than 100 cells/mm3, the others had intake CD4 counts of 350 cells/mm3 and above. Late diagnosis was the reason of late treatment in our sample. Most late presenters were not members of the key populations at increased risk of HIV (e.g., people who inject drugs, commercial sex workers, and men who have sex with men). Individual-level factors included low risk appraisal, habit of self-medication, and fear of stigma. Network and structural-level factors included challenges to access quality health care, normalization of HIV testing in key populations and inconsistent provider-initiated HIV testing practices. Structural interventions coupled with existing key population-targeted strategies would improve the issue of late HIV diagnosis.

中文翻译：

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越南的晚期艾滋病毒诊断是什么？多层次因素的定性研究。

尽管付出了巨大的努力，但晚期艾滋病毒治疗仍然是一个全球公共卫生问题。为了更好地理解这一问题的形成原因，我们采访了 2017 年接受 HIV 治疗的 36 名越南 ART 初治患者。其中一半人摄入的 CD4 计数低于 100 个细胞/mm3，其他人摄入的 CD4 计数为 350 个细胞/mm3 和以上。晚诊断是我们样本中治疗晚的原因。大多数迟到的演讲者不是艾滋病毒感染风险增加的关键人群（例如，注射毒品者、商业性工作者和男男性行为者）。个体层面的因素包括低风险评估、自我药疗习惯和对耻辱的恐惧。网络和结构层面的因素包括获得优质医疗保健的挑战、重点人群中 HIV 检测的正常化和提供者发起的 HIV 检测实践不一致。结构性干预措施与现有的主要针对人群的战略相结合，将改善艾滋病毒晚期诊断的问题。