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HIV-1 late diagnosis in Cabo Verde: associated factors and implications for preventive strategies

Silvânia da Veiga Leal1,2, Mafalda N S Miranda2, Ricardo Parreira2

  • 1Instituto Nacional de Saúde Pública de Cabo Verde, Largo do Desastre da Assistência, Chã de Areia, Praia, Cabo Verde.

Frontiers in Epidemiology
|June 29, 2026
PubMed

Insights

Late HIV diagnosis is common in Cabo Verde, affecting over half of new cases. Being single and having a high viral load are key risk factors for delayed diagnosis.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Late diagnosis of HIV remains a significant public health issue globally.
  • It is associated with increased morbidity, mortality, transmission, and healthcare costs.
  • In Cabo Verde, prevalence and determinants of late HIV diagnosis are not well understood despite free testing and treatment access.

Purpose of the Study:

  • To determine the prevalence of late HIV diagnosis in Cabo Verde.
  • To identify factors associated with late HIV diagnosis among newly diagnosed, treatment-naïve individuals.

Main Methods:

  • A cross-sectional study was conducted from 2018-2019 on 135 newly diagnosed, treatment-naïve HIV-1 individuals across four islands.
  • Late diagnosis was defined as CD4+ count <350 cells/µL or an AIDS-defining condition.
  • Data were collected through interviews and clinical records; logistic regression analyzed associations.

Main Results:

  • Over half (56.3%) of individuals presented with late HIV diagnosis.
  • Being single (aOR: 2.79) and having a viral load ≥5.0 log copies/mL (aOR: 5.24) were independently associated with late diagnosis.
  • Genetic analysis indicated mostly recent infections with low CD4+ T-cell count concordance.

Conclusions:

  • Late HIV diagnosis is highly prevalent in Cabo Verde, linked to single marital status and high viral load.
  • Findings indicate gaps in early testing and linkage to care.
  • Targeted testing strategies are crucial to improve outcomes and reduce transmission, aligning with UNAIDS goals.
Abstract

Keywords:
CD4+ T lymphocyteCabo VerdeHIV-1 infectionassociated factorsepidemiologygeneticlate HIV diagnosis

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