Factors associated with late HIV diagnosis in North-East Scotland: a six-year retrospective study

G. Noble, E. Okpo, I. Tonna, S. Fielding

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6 Downloads (Pure)

Abstract

Objectives
Late HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.

Study design
A population based retrospective database analysis.

Methods
All newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests.

Results
CD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants.

Conclusion
Heterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.
Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalPublic Health
Volume139
Early online date5 Jul 2016
DOIs
Publication statusPublished - Oct 2016

Fingerprint

Delayed Diagnosis
Scotland
Retrospective Studies
HIV
Heterosexuality
CD4 Lymphocyte Count
Health Care Costs
Cell Count
Economics
Demography
Databases
Morbidity
Mortality
Population

Keywords

  • HIV
  • late diagnosis
  • missed diagnosis
  • CD4 cell count

Cite this

Factors associated with late HIV diagnosis in North-East Scotland : a six-year retrospective study. / Noble, G.; Okpo, E.; Tonna, I.; Fielding, S.

In: Public Health, Vol. 139, 10.2016, p. 36-43.

Research output: Contribution to journalArticle

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abstract = "ObjectivesLate HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.Study designA population based retrospective database analysis.MethodsAll newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests.ResultsCD4 cell count results were available for 111 (89.5{\%}) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2{\%} (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95{\%} CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95{\%} CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3{\%} (n = 15) of participants.ConclusionHeterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.",
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author = "G. Noble and E. Okpo and I. Tonna and S. Fielding",
note = "Acknowledgements The authors would like to thank Drs. Steve Baguley, Ambreen Butt, and Daniela Brawley for their help with the review of case notes in the Genitourinary Medicine (GUM) Clinic. Ethical approval The study has been carried out in compliance with the Declaration of Helsinki.21 Ethical approval was granted by the North of Scotland Research Ethics Committee (REC reference 15/NS/0056). Funding None declared.",
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AU - Okpo, E.

AU - Tonna, I.

AU - Fielding, S.

N1 - Acknowledgements The authors would like to thank Drs. Steve Baguley, Ambreen Butt, and Daniela Brawley for their help with the review of case notes in the Genitourinary Medicine (GUM) Clinic. Ethical approval The study has been carried out in compliance with the Declaration of Helsinki.21 Ethical approval was granted by the North of Scotland Research Ethics Committee (REC reference 15/NS/0056). Funding None declared.

PY - 2016/10

Y1 - 2016/10

N2 - ObjectivesLate HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.Study designA population based retrospective database analysis.MethodsAll newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests.ResultsCD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants.ConclusionHeterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.

AB - ObjectivesLate HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.Study designA population based retrospective database analysis.MethodsAll newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests.ResultsCD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants.ConclusionHeterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.

KW - HIV

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KW - missed diagnosis

KW - CD4 cell count

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SN - 0033-3506

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