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Background: Late HIV diagnosis is associated with a wide range of negative outcomes. The aim of this study was to identify the characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations.

Methods: The NYS HIV registry was used to identify people who received a CDX from 2016 to 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates.

Results: There were 14,866 people newly diagnosed with HIV in NYS from 2016 to 2021, of which 19.0% had a CDX. Those with female sex at birth, history of injection drug use, or history of male-to-male sexual contact/history of injection drug use risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX.

Conclusion: Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics that may lead to delayed diagnostic testing.

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Titel:	Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021.
Autor/in / Beteiligte Person:	Rosenthal, M ; Patterson, W ; Rajulu, DT
Zeitschrift:	Journal of acquired immune deficiency syndromes (1999), Jg. 96 (2024-06-01), Heft 2, S. 130-135
Veröffentlichung:	Hagerstown, MD : Lippincott Williams & Wilkins, Inc., c1999-, 2024
Medientyp:	academicJournal
ISSN:	1944-7884 (electronic)
DOI:	10.1097/QAI.0000000000003414
Schlagwort:	Humans Male Female New York epidemiology Adult Middle Aged Adolescent Young Adult Delayed Diagnosis statistics & numerical data Acquired Immunodeficiency Syndrome diagnosis Acquired Immunodeficiency Syndrome epidemiology Risk Factors HIV Infections diagnosis HIV Infections epidemiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Acquir Immune Defic Syndr] 2024 Jun 01; Vol. 96 (2), pp. 130-135. MeSH Terms: HIV Infections* / diagnosis ; HIV Infections* / epidemiology ; Humans ; Male ; Female ; New York / epidemiology ; Adult ; Middle Aged ; Adolescent ; Young Adult ; Delayed Diagnosis / statistics & numerical data ; Acquired Immunodeficiency Syndrome / diagnosis ; Acquired Immunodeficiency Syndrome / epidemiology ; Risk Factors References: Gardner EM, McLees MP, Steiner JF, et al. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52:793–800. ; Bradley H, Hall HI, Wolitski RJ, et al. Vital signs: HIV diagnosis, care, and treatment among persons living with HIV--United States, 2011. MMWR Morb Mortal Wkly Rep. 2014;63:1113–1117. ; Hall HI, An Q, Tang T, et al. Prevalence of diagnosed and undiagnosed HIV infection--United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 2015;64:657–662. ; Pitasi MA, Delaney KP, Brooks JT, et al. HIV testing in 50 local jurisdictions accounting for the majority of new HIV diagnoses and seven states with disproportionate occurrence of HIV in rural areas, 2016-2017. MMWR Morb Mortal Wkly Rep. 2019;68:561–567. ; Centers for Disease Control and Prevention. Estimated HIV Incidence and Prevalence in the United States, 2015–2019. HIV Surveillance Supplemental Report. Centers for Disease Control and Prevention; 26; http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html (2021, July 24, 2023). ; Bureau of Chronic Disease Evaluation and Research. Data from: Behavioral Risk Factor Surveillance Survey; 2021. ; Valdiserri RO, Holtgrave DR, West GR. Promoting early HIV diagnosis and entry into care. AIDS. 1999;13:2317–2330. ; Centers for Disease Control and Prevention. Today’s HIV/AIDS Epidemic. Centers for Disease Control and Prevention; https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf (2016, July 24, 2023). ; Schwarcz S, Richards TA, Frank H, et al. Identifying barriers to HIV testing: personal and contextual factors associated with late HIV testing. AIDS Care. 2011;23:892–900. ; Waters L, Sabin CA. Late HIV presentation: epidemiology, clinical implications and management. Expert Rev Anti Infect Ther. 2011;9:877–889. ; Hanna DB, Pfeiffer MR, Torian LV, et al. Concurrent HIV/AIDS diagnosis increases the risk of short-term HIV-related death among persons newly diagnosed with AIDS, 2002-2005. AIDS Patient Care STDS. 2008;22:17–28. ; Mugavero MJ, Castellano C, Edelman D, et al. Late diagnosis of HIV infection: the role of age and sex. Am J Med. 2007;120:370–373. ; Girardi E, Sabin CA, Monforte AD. Late diagnosis of HIV infection: epidemiological features, consequences and strategies to encourage earlier testing. J Acquir Immune Defic Syndr. 2007;46(suppl 1):S3–S8. ; Brookmeyer R. Reconstruction and future trends of the AIDS epidemic in the United States. Science. 1991;253:37–42. ; Leeper C, Mugavero M, Willig J, et al. Social determinants of late presentation to HIV care. J Health Dispar Res Pract. 2014;7:37–47. ; Ransome Y, Terzian A, Addison D, et al. Expanded HIV testing coverage is associated with decreases in late HIV diagnoses. AIDS. 2015;29:1369–1378. ; New York State Department of Health. Ending the AIDS Epidemic in New York State. Available at: https://www.health.ny.gov/diseases/aids/ending_the_epidemic/#:∼:text=ETE. Updated 2023. Accessed July 17, 2023. ; Centers for Disease Control and Prevention. AIDS and Opportunistic Infections. Available at: https://www.cdc.gov/hiv/basics/livingwithhiv/opportunisticinfections.html. Updated May 20, 2021. Accessed July 17, 2023. ; USDA Economic Research Service. Rural-Urban Commuting Area Codes. United States Department of Agriculture. Available at: https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/. Updated March 22, 2023. Accessed July 17, 2023. ; US Census Bureau. ZIP Code Tabulation Areas (ZCTAs). Available at: https://www.census.gov/programs-surveys/geography/guidance/geo-areas/zctas.html. Updated May 16, 2022. Accessed July 17, 2023. ; SAS Institute Inc. Example 3.8 Cochran-Armitage Trend Test. Available at: https://documentation.sas.com/doc/en/pgmsascdc/9.4_3.5/procstat/procstat_freq_examples08.htm. Updated August 12, 2020. Accessed July 17, 2023. ; Park C, Hsiung J, Soohoo M, et al. Choosing wisely: using the appropriate statistical test for trend in SAS. Presented at: SAS Conference Proceedings: Western Users of SAS Software 2019. Seattle, WA: Western Users of SAS Software; https://www.lexjansen.com/wuss/2019/175_Final_Paper_PDF.pdf (2019, July 24, 2023). ; Adler A, Mounier-Jack S, Coker RJ. Late diagnosis of HIV in Europe: definitional and public health challenges. AIDS Care. 2009;21:284–293. Entry Date(s): Date Created: 20240521 Date Completed: 20240521 Latest Revision: 20240521 Update Code: 20240522

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Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021.