Late HIV Diagnosis: An Analysis of Predictors in Pennsylvania, USA: 2020-2024
Document Type : Original Article
Authors
- 1 Pennsylvania Department of Health
Abstract
Background: Late HIV diagnosis is defined as having AIDS within 3 months of HIV diagnosis representing missed opportunities for earlier HIV diagnosis, treatment, and prevention. This analysis assessed factors associated with late HIV diagnosis.
Methods: This is a retrospective cross-sectional analysis of de-identified HIV surveillance data for individuals newly diagnosed with HIV disease during 2020-2024. Descriptive and bivariate analyses characterized late diagnosis and assessed the association between independent variables (age, sex, race/ethnicity, and HIV transmission mode) and late diagnosis. Multivariable logistic regression analyses identified factors independently associated with late HIV diagnosis.
Results: 4,493 individuals were newly diagnosed with HIV from 2020 to 2024 and 23% were late diagnosis. Males had 45.3% higher adjusted odds of late diagnosis compared with females (aOR 1.45, 95% CI 1.182-1.787, p <.001). In comparison to individuals who acquired HIV through heterosexual contact, individuals who acquired HIV through male sex with male (MSM), Injection drug use (IDU) and MSM & IDU, all had lower odds of late diagnosis (MSM: aOR= 0.51, 95% CI 0.41-0.63, p=<.001; IDU: aOR = 0.34, 95% CI 0.24-0.49, p=<.001; MSM&IDU: aOR= 0.36, 95% CI 0.23-0.56, p=<.001). Each 10-year increase in age was associated with 51% higher adjusted odds of late diagnosis (aOR per 10 years= 1.51, 95% CI 1.17-1.95, p=.002).
Conclusions: Late HIV diagnosis remains a public health challenge, highlighting some gaps in timely HIV diagnosis. With older age, male sex, and heterosexual transmission being associated with greater odds of late diagnosis, we recommend more inclusive testing and expanded community outreach.
Methods: This is a retrospective cross-sectional analysis of de-identified HIV surveillance data for individuals newly diagnosed with HIV disease during 2020-2024. Descriptive and bivariate analyses characterized late diagnosis and assessed the association between independent variables (age, sex, race/ethnicity, and HIV transmission mode) and late diagnosis. Multivariable logistic regression analyses identified factors independently associated with late HIV diagnosis.
Results: 4,493 individuals were newly diagnosed with HIV from 2020 to 2024 and 23% were late diagnosis. Males had 45.3% higher adjusted odds of late diagnosis compared with females (aOR 1.45, 95% CI 1.182-1.787, p <.001). In comparison to individuals who acquired HIV through heterosexual contact, individuals who acquired HIV through male sex with male (MSM), Injection drug use (IDU) and MSM & IDU, all had lower odds of late diagnosis (MSM: aOR= 0.51, 95% CI 0.41-0.63, p=<.001; IDU: aOR = 0.34, 95% CI 0.24-0.49, p=<.001; MSM&IDU: aOR= 0.36, 95% CI 0.23-0.56, p=<.001). Each 10-year increase in age was associated with 51% higher adjusted odds of late diagnosis (aOR per 10 years= 1.51, 95% CI 1.17-1.95, p=.002).
Conclusions: Late HIV diagnosis remains a public health challenge, highlighting some gaps in timely HIV diagnosis. With older age, male sex, and heterosexual transmission being associated with greater odds of late diagnosis, we recommend more inclusive testing and expanded community outreach.