1). buy Pirfenidone When multivariate analysis was repeated using the variable ‘stage of the epidemic’ instead of calendar periods, later stage of the outbreak was found to be a strong independent predictor (OR 4.3, 95% CI 2.5–7.4) for late diagnosis. In the first 4-year interval of the sub-epidemics among IDU, MSM and heterosexual transmissions, the proportion of late diagnosis was 6%, 13% and 18%, respectively, but increased thereafter (37%, 29% and 27%, respectively). Repeating the analysis using the general introduction of cART as a cut-off point did not change the proportion of late-diagnosed

cases among heterosexual and MSM transmissions. The IDUs were excluded in this analysis, as the outbreak occurred after 1997. Of the heterosexually transmitted cases, 71% were diagnosed HIV positive in primary or secondary health care settings, whereas the proportion among MSM and IDU groups was 56% and 40%, respectively. Prisons, needle exchange sites or drug treatment facilities diagnosed 49% of HIV cases among IDUs (Table 3). Despite the stable trend over calendar periods in all Dabrafenib research buy diagnosis made in health care settings, primary health care diagnosis decreased from 35% to 13% (P=0.028) among late-diagnosed cases. During the study period, the proportion of those who reported

earlier testing increased from 19% to 56% (P<0.001). Earlier testing was reported by 33% of late-diagnosed cases, and 49% of non-late cases (P<0.001). Of heterosexuals, 38% were tested HIV negative earlier, whereas the proportions were 48% and 50% among MSM and IDUs, respectively. Out of ethnically Finnish individuals, 48% were tested earlier, whereas the proportion among non-Finnish individuals was 29% (P<0.001). The median delay from HIV diagnosis to the first visit at the Infectious Disease Cisplatin Clinic was 1.3 months. The delay

was shortest for female heterosexuals (median 1.1 months) and longest for male IDUs (median 2 months). Out of all diagnosed cases, 11% were delayed for more than 6 months and 4% for more than 2 years. Out of the IDUs, 20% were delayed for more than 6 months. In the multivariate model, delayed entry to care was more common among IDUs, non-Finnish individuals, those who had not been HIV tested earlier and those diagnosed before the year 1998 (Table 4). When the analysis was repeated with only those cases who had their CD4 cell count measured within 90 days after the HIV-positive test, 783 patients were included and the proportion and predictors of late diagnosis were comparable. A relatively larger proportion of IDUs were excluded compared with heterosexuals or MSM as were non-Finnish compared with Finnish individuals. The present data provide unique longitudinal trends in newly diagnosed HIV infections that extend over two decades in a low-prevalence country. The study period includes the early phases of the sexual epidemics in the 1980s, and a more recent outbreak among IDUs starting in the late 1990s.