Expanded HIV testing coverage is associated with decreases in late HIV diagnoses

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Expanded HIV testing coverage is a key strategy for earlier Human Immunodeficiency Virus (HIV) diagnosis.
• Earlier diagnosis can reduce HIV-related morbidity, mortality, and transmission.

Purpose of the Study:

• To examine the association between changes in recent HIV testing coverage and late HIV diagnosis rates.
• To assess these associations within New York City (NYC) ZIP codes during a period of increased HIV testing.

Main Methods:

• Longitudinal analysis of aggregate, population-based surveillance data from NYC ZIP codes (2003-2010).
• Examined new HIV diagnoses and recent HIV testing rates to determine associations with late HIV diagnosis rates.

Main Results:

• Recent HIV testing coverage increased from 23% to 31% between 2003-2010, while late HIV diagnoses decreased.
• A 10% increase in testing coverage was associated with a 2.5 per 100,000 decrease in late diagnoses.
• Significant declines in late diagnoses were observed among men in areas with increased testing coverage (aOR=4.0).

Conclusions:

• Increases in recent HIV testing coverage may contribute to reduced rates of late HIV diagnoses, especially in men.
• Persistent geographic disparities in late diagnosis rates highlight the need for continued HIV testing expansion.
• Promoting earlier HIV diagnosis remains a critical public health objective.