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Risk factors for late HIV diagnosis in England, 2015-2023.

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This summary is machine-generated.

Late HIV diagnosis is common in England, particularly among older adults and ethnic minorities. Targeted testing strategies are crucial to reduce mortality and transmission risks.

Keywords:
HIVHIV testinglate diagnosislate presentationrisk factors

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Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Surveillance

Background:

  • Late diagnosis of Human Immunodeficiency Virus (HIV) is associated with increased mortality and onward transmission.
  • Effective HIV testing strategies are essential to mitigate these risks.

Purpose of the Study:

  • To analyze risk factors associated with late HIV diagnosis in England.
  • To inform the development of targeted HIV testing strategies.

Main Methods:

  • Analysis of national HIV surveillance data for England residents aged 15+ (2015-2023).
  • Inclusion of individuals with likely sexual transmission of HIV.
  • Definition of late diagnosis: CD4 count <350 cells/mm³ within 91 days, no recent infection evidence.
  • Multivariable logistic regression to identify risk factors.

Main Results:

  • 39% of 18,217 HIV diagnoses were late.
  • Older age (aOR: 1.44 per 10 years) was a significant risk factor.
  • Non-UK-born individuals of Asian (aOR: 1.69) and Black African (aOR: 1.43) ethnicity had higher risks.
  • Predicted late diagnosis probability increased for men who have sex with men (MSM) from 21% to 32% (2015-2023).

Conclusions:

  • Prioritize targeted and accessible HIV testing beyond sexual health services.
  • Focus on older adults, individuals exposed through sex between men and women, and non-UK-born ethnic minorities.
  • These strategies aim to reduce late diagnoses and improve health outcomes.