Predictors of Antiretroviral Treatment Initiation Among Foreign‐Born HIV Patients in Ontario: Perspectives from the OHTN Cohort Study
Bibliographic record
Abstract
Inequalities in the provision of antiretroviral therapy (ART), used in the treatment of HIV, to infected foreign‐born patients have been documented in the developed world. However, there has been no systematic survey of this phenomenon for Ontario. This study aims to explore whether treatment inequalities exist between Canadian‐born and foreign‐born HIV‐infected persons living in Ontario by assessing immunologic status at initiation of ART. We conducted a retrospective analysis of HIV‐infected patients registered in the Ontario Cohort Study. Patients were stratified according to region of birth. Median CD4 cell count at ART initiation was compared for Canadian‐born and foreign‐born patients. Bivariate analysis of sex, age at diagnosis, age at ART initiation, most recent CD4 cell count, time from diagnosis to ART initiation and proportion of patients initiating ART at CD4 cell count <200 cells/μl was also undertaken. 2717 patients were included in the analysis. 1969 were Canadian‐born and 747 were foreign‐born. Canadian‐born patients also had a greater proportion of males, greater time from diagnosis to ART initiation and earlier age of diagnosis. Foreign‐born patients are more likely to initiate ART at CD4 cell count <200 cells/μl. Immunologic response to ART showed similar increases in CD4 cell count from baseline for all world region of birth groups. The findings indicate shifting trends in the population of persons afflicted by HIV. Differences were noted between the Canadian‐born and foreign‐born demographic with respect to immunologic, demographic and socioeconomic characteristics underscoring the need for new socio‐cultural paradigms in HIV treatment stratagems.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".