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Meta-Analysis
. 2022 Mar 1;24(1):32-40.
doi: 10.24875/AIDSRev.21000007.

A Systematic Review and Meta-analysis to Estimate the Time from HIV Infection to Diagnosis for People with HIV

Semiu O Gbadamosi  1 , Mary Jo Trepka  2 , Rahel Dawit  1 , Rime Jebai  1 , Diana M Sheehan  3
Affiliations
Meta-Analysis

A Systematic Review and Meta-analysis to Estimate the Time from HIV Infection to Diagnosis for People with HIV

Semiu O Gbadamosi et al. AIDS Rev. .

Abstract

Timely HIV diagnosis is critical to minimizing transmission events. We sought to estimate the meantime from HIV infection to diagnosis and its temporal trend among people with HIV. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of MEDLINE, Embase, and Google Scholar, supplemented by a hand search of bibliographies of articles, was conducted. Study information and outcome measures of time from HIV infection to diagnosis were synthesized. Random-effects metaanalyses were performed. The search identified 12 articles from 4541 unduplicated citations. Studies were conducted in the UK (k = 3), US (k = 3), France (k = 2), Australia (k = 1), Switzerland (k = 1), Netherlands (k = 1), and China (k = 1). The pooled meantime from HIV infection to diagnosis was 3.00 years (95% confidence interval: 2.16-3.84). From 1996 to 2002, meantime reduced from 4.68 to 2.66 years. Subsequently, it increased to 3.20 years in 2003 and remained relatively stable until 2015. In sub-group meta-analyses, men who have sex with men (MSM) had a meantime of 2.62 years (1.91-3.34), while for heterosexuals and people who inject drugs, it was 5.00 (4.15-5.86) and 4.98 (3.97-5.98) years, respectively. In the high- and upper-middle-income countries included in this study, persons live with undiagnosed HIV for about 3 year before being diagnosed. This period is shorter for MSM relative to people with infections attributable to other risk factors.

Keywords: HIV diagnosis; HIV testing; HIV screening; Delayed diagnosis; Systematic review; Meta-analysis.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart for the search strategy and inclusion of studies reporting time from HIV infection to diagnosis conducted from 1996–2015
Fig. 2
Fig. 2
Forest plot of individual study and pooled mean and 95% confidence intervals (CI) of time from HIV infection to diagnosis, k=7
Fig. 3a
Fig. 3a
Forest plot of individual study and pooled mean and 95% confidence intervals (CI) of time from HIV infection to diagnosis among individuals with infection attributed to (a) male-to-male sexual contact only, k=6 (b) heterosexual contact only, k=4 (c) injection drug use only, k=5
See this image and copyright information in PMC

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