Increasing proportion of late diagnosis of HIV infection among patients with AIDS in Italy following introduction of combination antiretroviral therapy
- PMID: 11064507
- DOI: 10.1097/00042560-200009010-00010
Increasing proportion of late diagnosis of HIV infection among patients with AIDS in Italy following introduction of combination antiretroviral therapy
Abstract
We analyzed trends over time and determinants of late diagnosis of HIV infection among people diagnosed with AIDS in 1986 to 1998 in a tertiary care center in Rome, Italy. Information on the date of a first HIV test was collected prospectively, in addition to data routinely collected for AIDS reporting. Patients with AIDS were defined as "late testers" if the time interval between first positive HIV test result and AIDS diagnosis was < or = 3 months. Overall, 503 people with AIDS of 1977 included in the analysis (25.4%) were late testers. the proportion of late testers decreased from 62.5% in 1986 to 16% in 1995. Thereafter, this proportion increased to 20.5% in 1996, 33.7% in 1997, and 36.6% in 1998. In multivariate analysis, the following variables were significantly associated with late testing: AIDS diagnosis in years 1986 to 1993 or 1997 to 1998 compared with 1995, male gender, age > or = 45 years, men who have sex with men, heterosexual contacts, or having unknown transmission mode compared with intravenous drug users, and being born outside Italy. Since 1996, the overall number of AIDS cases diagnosed at our center began to decrease whereas the number of late-testing AIDS patients did not decrease, resulting in an increasing proportion of late testers during the last 3 years of the study. This findings may reflect the effect of combination antiretroviral therapy in slowing progression to AIDS of HIV-infected persons aware of their status. A relevant number of people still discover their HIV infection late and may therefore miss treatment opportunities. New testing strategies are needed to reach more people who engage in high-risk behaviors, especially those at risk for sexual transmission, and those born outside Italy.
Similar articles
-
Increasing proportion of late testers among AIDS cases in Italy, 1996-2002.AIDS Care. 2005 Oct;17(7):834-41. doi: 10.1080/09540120500038397. AIDS Care. 2005. PMID: 16120500
-
The persistent problem of late HIV diagnosis in people with AIDS: a population-based study in Italy, 1999-2013.Public Health. 2017 Jan;142:39-45. doi: 10.1016/j.puhe.2016.10.009. Epub 2016 Nov 18. Public Health. 2017. PMID: 28057195
-
Characteristics and behaviors in a sample of patients unaware of their infection until AIDS diagnosis in Italy: a cross-sectional study.AIDS Care. 2011 Sep;23(9):1067-75. doi: 10.1080/09540121.2011.554525. Epub 2011 Jun 1. AIDS Care. 2011. PMID: 21480007
-
The epidemiology of the acquired immunodeficiency syndrome in the 1990s.Emerg Med Clin North Am. 1995 Feb;13(1):1-25. Emerg Med Clin North Am. 1995. PMID: 7851311 Review.
-
The epidemiology of HIV and AIDS in the United States.AIDS Clin Rev. 1997-1998:1-45. AIDS Clin Rev. 1997. PMID: 9305442 Review.
Cited by
-
'Slipping through the cracks': policy implications of delays in HIV treatment seeking.Glob Public Health. 2012;7(10):1095-108. doi: 10.1080/17441692.2012.701318. Epub 2012 Jul 19. Glob Public Health. 2012. PMID: 22813066 Free PMC article.
-
Cascade of care among HIV patients diagnosed in 2013 in Georgia: Risk factors for late diagnosis and attrition from HIV care.SAGE Open Med. 2017 Sep 21;5:2050312117731977. doi: 10.1177/2050312117731977. eCollection 2017. SAGE Open Med. 2017. PMID: 28975029 Free PMC article.
-
Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in Sub-Saharan Africa.J Acquir Immune Defic Syndr. 2009 Oct 1;52(2):280-9. doi: 10.1097/QAI.0b013e3181ab6eab. J Acquir Immune Defic Syndr. 2009. PMID: 19521248 Free PMC article.
-
Comparing Measures of Late HIV Diagnosis in Washington State.AIDS Res Treat. 2012;2012:182672. doi: 10.1155/2012/182672. Epub 2011 Nov 15. AIDS Res Treat. 2012. PMID: 22162804 Free PMC article.
-
Determinants of progression to AIDS and death following HIV diagnosis: a retrospective cohort study in Wuhan, China.PLoS One. 2013 Dec 23;8(12):e83078. doi: 10.1371/journal.pone.0083078. eCollection 2013. PLoS One. 2013. PMID: 24376638 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical