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. 2024 Jan 31;12(3):361.
doi: 10.3390/healthcare12030361.

Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities

Víctor Giménez-Arufe  1 , Sandra Rotea-Salvo  1 , Alejandro Martínez-Pradeda  1 , Álvaro Mena-de-Cea  2   3 , Luis Margusino-Framiñán  1   2 , Jorge Suanzes-Hernández  4 , María Isabel Martín Herranz  1 , Purificación Cid-Silva  1   2
Affiliations

Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities

Víctor Giménez-Arufe et al. Healthcare (Basel). .

Abstract

Early diagnosis of a Human Immunodeficiency Virus (HIV)-infected person represents a cornerstone of HIV prevention, treatment, and care. Numerous publications have developed recommendations where HIV serology is indicated to reduce missed diagnostic opportunities (MDOs). This retrospective study analyses new HIV infection diagnoses and the relationship between late diagnosis (LD)/advanced HIV disease (AHD), baseline characteristics, and MDOs. Sociodemographic data and data related to contact with the health system in the 5 years before diagnosis were collected. Most of the 273 diagnoses were made in primary care (48.5%). Approximately 50.5% and 34.4% had LD and AHD criteria, respectively. Female sex was associated with a higher incidence of LD. Persons infected through the heterosexual route and those at an older age had a higher risk for LD and AHD. People with previous HIV serology presented a lower percentage of LD and AHD. In total, 10% of the health contact instances were classified as MDOs, mostly occurring in primary care. A significant increase in the median of MDOs was observed in patients with LD/AHD. Female sex and hepatitis C virus co-infection were associated with an increase in the number of MDOs. The high percentage of LD and AHD and the significant number of MDOs show that the current screening system should be improved.

Keywords: HIV infection diagnosis; HIV/AIDS; delayed diagnosis; health screening; missed opportunities.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Missed diagnostic opportunities by indicator condition and evolution of the percentage of Missed diagnostic opportunities per year. STDs: Sexually transmitted diseases; CAP: Community-acquired pneumonia; MAC: Mycobacterium avium complex; IVDU: Intravenous drug users; HTX: heterosexual; APC: Annual Percent Change. * APC is significantly different from zero at the alfa = 0.05 level.
Figure 2
Figure 2
Missed diagnostic opportunities grouped into four clusters. CI: confidence interval.
See this image and copyright information in PMC

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