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HIV testing patterns: where, why, and when were persons with AIDS tested for HIV?
1Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Insights
Many individuals diagnosed with AIDS received their first positive HIV test late in their infection, often due to illness in healthcare settings. This delayed testing hinders early intervention and may increase HIV transmission risks.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Research
Background:
- Delayed diagnosis of Human Immunodeficiency Virus (HIV) infection can impede timely medical care and potentially increase transmission rates.
- Understanding the circumstances surrounding HIV testing and AIDS diagnosis is crucial for developing effective public health interventions.
Purpose of the Study:
- To investigate the timing, location, and reasons for HIV testing among individuals with newly diagnosed Acquired Immunodeficiency Syndrome (AIDS).
- To identify patterns in HIV testing practices in relation to AIDS diagnosis.
Main Methods:
- Interviews were conducted with 2441 individuals diagnosed with AIDS between January 1990 and December 1992 in eleven US states and cities.
- Data collected supplemented routine AIDS case reporting, focusing on the location of the first positive HIV test, the primary reason for testing, and the time interval to AIDS diagnosis.
Main Results:
- A significant proportion of individuals were tested late in their HIV infection, with 51% tested within one year of their AIDS diagnosis.
- Most HIV testing occurred in acute healthcare settings (65%), primarily hospitals (33%) and physicians' offices (28%), often prompted by illness (58%).
- Testing patterns and reasons varied by exposure category and race/ethnicity.
Conclusions:
- The study highlights that most individuals diagnosed with AIDS were tested late in their HIV disease course, often in acute care settings due to illness.
- Late HIV diagnosis prevents early medical intervention, potentially exacerbating disease progression and increasing the risk of HIV transmission.
- Findings underscore the need for improved strategies to promote earlier HIV testing and diagnosis.
Objective:
To describe the location of, primary reason for, and time between the first positive HIV test and AIDS diagnosis in a sample of persons with newly diagnosed AIDS.
Design:
Interviews supplementing information routinely collected through AIDS case reporting.
Setting:
Eleven US states and cities.
Patients:
Persons with AIDS (2441) diagnosed between January 1990 and December 1992.
Main Outcome Measures:
Location of first positive HIV test, primary reason for testing, and time interval between first positive HIV test and AIDS diagnosis.
Results:
Overall, persons were tested late in their course of HIV infection: 36% were tested for HIV within 2 months and 51% within 1 year of their AIDS diagnosis. Sixty-five per cent were HIV-tested in acute health-care settings: 33% in hospitals, 28% in physicians' offices, and 4% in emergency departments. Testing during hospitalization was most common among injecting drug users (43%) and persons infected through heterosexual contact (50%). Persons primarily sought HIV testing because of illness (58%); other reasons included being in a known risk group (13%) and having had a known HIV-infected sex partner (8%). Testing because of being in a known risk group was least common among persons infected through heterosexual contact (1%). Among persons in these exposure categories, testing differed by race/ethnicity.
Conclusion:
Most persons with AIDS were tested relatively late in their course of HIV infection, in acute health-care settings, and because of illness. Not knowing one's serostatus precludes early medical intervention and may increase transmission.