Abstract:Introduction: In recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation ('presenting for care with a CD4 count < 350 cells/μL or an AIDS-defining event, regardless of CD4 count') these individuals would be incorrectly assigned as being diagnosed late. Methods: In spring 2022, a European expert group convened to revise the current late HIV presentation cons… Show more
“…Late HIV diagnosis is defined as a CD4 count below 350 cells/mm³ of blood within 91 days of diagnosis, excluding individuals with evidence of recent HIV acquisition (either a negative test in the 24 months before their first positive HIV test, or the result of a Recent Infection Testing Algorithm). 10,11 and health-seeking behaviour (including reduced access to sexual health services) may have contributed to the increase in the proportion of late HIV diagnoses seen in 2020 and 2021. 10 Mortality also increased markedly during the COVID-19 pandemic, underlining the consequences of late diagnosis.…”
Section: Hiv Diagnosismentioning
confidence: 99%
“…9 Definition of late HIV diagnosis.Late HIV diagnosis is defined as a CD4 count below 350 cells/mm³ of blood within 91 days of diagnosis, excluding individuals with evidence of recent HIV acquisition (either a negative test in the 24 months before their first positive HIV test, or the result of a Recent Infection Testing Algorithm). 10,11 …”
Introduction Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally. Objective To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested. Conclusions Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.
“…Late HIV diagnosis is defined as a CD4 count below 350 cells/mm³ of blood within 91 days of diagnosis, excluding individuals with evidence of recent HIV acquisition (either a negative test in the 24 months before their first positive HIV test, or the result of a Recent Infection Testing Algorithm). 10,11 and health-seeking behaviour (including reduced access to sexual health services) may have contributed to the increase in the proportion of late HIV diagnoses seen in 2020 and 2021. 10 Mortality also increased markedly during the COVID-19 pandemic, underlining the consequences of late diagnosis.…”
Section: Hiv Diagnosismentioning
confidence: 99%
“…9 Definition of late HIV diagnosis.Late HIV diagnosis is defined as a CD4 count below 350 cells/mm³ of blood within 91 days of diagnosis, excluding individuals with evidence of recent HIV acquisition (either a negative test in the 24 months before their first positive HIV test, or the result of a Recent Infection Testing Algorithm). 10,11 …”
Introduction Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally. Objective To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested. Conclusions Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.
“…43 In the current Recently, it has been suggested that the current casesurveillance definition of late diagnosis has the potential to overestimate "late diagnosis" due to low CD4 levels at the time of seroconversion, especially in frequently tested patient groups, and various suggestions have been made to overcome this issue. [62][63][64] This study was conducted by taking into account the existing consensus definitions.…”
Section: Factors Associated With Late Presentation and Late Presentat...mentioning
To identify the frequency of late presentation and late presentation with advanced disease, and associated factors in people living with HIV (PLHIV). Data from PLHIV diagnosed between 2008 and 2021 were retrospectively analyzed. Time of diagnosis (categorized based on key events affecting HIV care continuum e.g., national strategies, HIV guidelines, COVID-19 pandemic) and characteristics of late presenters (LP: CD4 ≤350 cells/mm³ or an AIDS defining event) and late presenters with advanced disease (LPAD: CD4 <200 cells/mm³) were describe. Associations between dependent (LP, LPAD) and independent variables were assessed using univariate/multivariate regression tests and presented as odds ratios (95% confidential interval). Of 1585 individuals (93.7% men), 42.5% were LPs and 19.3% were LPADs. Most common route of transmission was sex between men (54.3%). Non-LPs were younger (30 vs. 34 and 36 years; p < 0.001) and included more men who have sex with men (60.3% vs. 46.3% and 39.5%; p < 0.001). Factors associated with being LP and LPAD were age >30 years, heterosexual/unknown route of transmission (vs. sex between men), diagnosis in 2008−2013 or 2020−2021, (vs. 2014−2019). With reference to Turkish subjects, migrants from Africa had higher odds of being LPAD. LP is still an important health issue in HIV care. Heterosexuality, older age (>30 years), migration from Africa, and the COVID-19 pandemic are associated with delays in HIV presentation in Turkey. These factors need to be considered when developing and implementing policies to enable earlier diagnosis and treatment of PLHIV to achieve UNAIDS 95-95-95 targets.
“…Late diagnosis of HIV and viral hepatitis continues to be a problem across Europe and beyond. An estimated one in five people living with HIV do not know their status, and half are diagnosed late in the World Health Organization (WHO) European region [1][2][3][4]. An estimated 80% of people with hepatitis B virus (HBV) infection and 73% of those with hepatitis C virus (HCV) infection are unaware of their infection in the European Union (EU)/European Economic area (EEA) [5].…”
IntroductionSince 2013, the European Testing Week (ETW) awareness campaign has become a key regional event influencing testing efforts for HIV, viral hepatitis, and sexually transmitted infections (STIs) through participation of 720 organizations. Here, we report on a survey from May to June 2022 aimed at assessing the participant‐reported impact of the campaign.MethodsAll past and current participating organizations were asked to complete an online questionnaire between 12 May and 17 June 2022. Multiple choice and open‐text questions included organization information, usage of ETW to engage in local testing‐related activities, and the effect of a regional campaign to reach a wider audience and generate impact.ResultsOf the 52 respondents, 34 (65%) stated first participating in ETW 5–10 years ago. ETW was used for awareness raising by 40 respondents (83%), new testing activities by 37 (77%), advocacy initiatives by 15 (31%), and training/capacity building by 18 (38%). For awareness raising, 95% used ETW to highlight the importance of and to encourage testing; for new testing activities, 74% used ETW to reach new groups. In total, 44 (85%) reported added benefits of a Europe‐wide campaign compared with national/local campaigns, particularly the increased visibility and collaboration opportunities. Impact at the local level was observed by 24 (51%), and impact at a national level was observed by 20 (43%). A total of 28 (79%) reported increases in the number of tests performed and 25 (75%) reported increases in clients accessing services.ConclusionsRegional awareness campaigns reach wider audiences, boost local and national efforts to increase testing, and sensitize key populations about the critical value of testing compared with local/national campaigns.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
