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Public Health. 2016 Oct;139:36-43. doi: 10.1016/j.puhe.2016.06.007. Epub 2016 Jul 5.

Factors associated with late HIV diagnosis in North-East Scotland: a six-year retrospective study.

Author information

1
Institute of Applied Health Sciences, Postgraduate Education Department, University of Aberdeen, Aberdeen, Scotland, UK.
2
Institute of Applied Health Sciences, Postgraduate Education Department, University of Aberdeen, Aberdeen, Scotland, UK; Public Health Department, NHS Grampian, Summerfield House, 2 Eday Road, Aberdeen, AB15 6RE, UK. Electronic address: emmanuel.okpo@nhs.net.
3
Aberdeen Royal Infirmary, Infectious Diseases Department, Emergency Care Centre, Aberdeen, UK.
4
Institute of Applied Health Sciences, Medical Statistics Department, University of Aberdeen, Aberdeen, Scotland, UK.

Abstract

OBJECTIVES:

Late HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.

STUDY DESIGN:

A population based retrospective database analysis.

METHODS:

All newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann-Whitney tests.

RESULTS:

CD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10-7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89-15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants.

CONCLUSION:

Heterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.

KEYWORDS:

CD4 cell count; HIV; Late diagnosis; Missed diagnosis

PMID:
27393624
DOI:
10.1016/j.puhe.2016.06.007
[Indexed for MEDLINE]

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