Late HIV presentation among AIDS cases in Australia, 1992–2001

Abstract

Objective: To describe time trends and demographic, exposure and clinical factors associated with late HIV presentation among notified AIDS cases diagnosed in Australia in 1992–2001. Methods: AIDS cases, diagnosed in Australia and notified to the National AIDS Registry, were included in the analysis. AIDS cases newly diagnosed with HIV infection within three months of AIDS diagnosis were defined as cases of late HIV presentation. Results: The percentage of AIDS cases with late HIV presentation increased significantly from 18% in 1992–96 to 33.1% in 1997 (adjusted odds ratio (AOR)=1.79, p<0.005) and to 49.6% in 2001 (AOR=3.01, p<0.005). Older age, having been born in Asia, a HIV exposure history of heterosexual contact or an ‘other/undetermined’ exposure and a diagnosis of PCP only or of multiple AIDS illnesses, were associated with late HIV presentation among AIDS cases diagnosed in 1992–96 and in 1997–2001, and among overseas‐born cases diagnosed in 1992–2001. In 1997–2001, a low CD4+ cell count was also associated with late HIV presentation. Among homosexually active men diagnosed with AIDS in 1997–2001, older age, a diagnosis of PCP or multiple AIDS illnesses and a low CD4+ cell count were associated with late HIV presentation. Conclusion: Predictors of late HIV presentation have remained substantially unchanged over time and among population subgroups, suggesting a need for innovation in HIV/AIDS testing and counselling strategies.

Determinants and Prevalence of Late HIV Testing in Tijuana, Mexico

“…Previous studies in several countries have identified variables positively associated with late HIV testing or delayed diagnosis including: heterosexual transmission [2][3][4]6,13,14 ; male gender 4,5,7,15 ; both older 2,4,5,7,[16][17][18][19] and younger 3,13,20 age; foreign-born status [3][4][5][6]13 ; belonging to racial=ethnic minority populations 14,20 ; residing in areas with lower AIDS incidence 3,5 ; being less educated 16,20 ; and having tested negative for HIV prior to the first positive HIV test. 20 Whether these or other factors are correlated to late HIV testing in the San Diego-Tijuana region is unknown.…”

“…1 Despite the benefits of timely identification of HIV infection, little or no progress has been made in effecting earlier diagnoses. [2][3][4][5][6][7] Mexico is a country with an HIV prevalence of 0.3%, 8 which is lower than its neighboring countries (i.e., Belize, 2.0%; Guatemala, 1.0%; Honduras, 1.6%; United States, 0.6%). 9 However, HIV=AIDS rates vary widely across the country.…”

A feasible method for linkage studies avoiding clerical review: linkage of the national HIV/AIDS surveillance databases with the National Death Index in Australia

“…12 All HIV cases diagnosed by State reference laboratories are reported to State health departments and are subsequently registered with the NHD. 13 …”

An old enzyme for current needs: adenosine deaminase and a dendritic cell vaccine for HIV

“…In Papua New Guinea, males and females are equally likely to become infected, with the risk of infection growing among young women (Coghlan et al, 2009;National AIDS Council Secretariat, 2008 In Australia, the proportion of AIDS diagnoses that occur around the time of HIV diagnosis rose from 31% in 1997 to 56% in 2006 (Department of Health and Ageing, 2008). Individuals with heterosexually acquired HIV infection or who were born in Asia are most likely to be diagnosed late in the course of infection in Australia (McDonald et al, 2007;Körner, 2007).…”