July 29, 2011
Late diagnosis of HIV, which is associated with increased morbidity, mortality, and health care costs, continues to occur despite the availability of HIV testing. In the current study, researchers accessed the HIV/AIDS case registry of the San Francisco Department of Public Health to identify individuals who developed AIDS within 12 months of their HIV diagnosis; 41 such patients were recruited to participate in qualitative and quantitative interviews.
Among the participants, 31 were diagnosed with HIV due to symptomatic disease. Fifty percent were diagnosed with HIV and AIDS concurrently. Half the patients had never been tested for HIV prior to diagnosis.
Barriers to HIV testing included fear (cited most frequently), and being unaware of improved HIV treatment, free/low-cost care and risk for HIV. "Recommendations for health care providers to increase early diagnosis of HIV include routine ascertainment of HIV risk behaviors and testing histories, stronger recommendations for patients to be tested, and incorporating testing into routine medical care," the authors wrote.
"Public health messages to increase testing include publicizing that (1) effective, tolerable, and low-cost/free care for HIV is readily available; (2) early diagnosis of HIV improves health outcomes; (3) HIV can be transmitted to persons who engage in unprotected oral and insertive anal sex and unprotected receptive anal intercourse without ejaculation and from HIV-infected persons whose infection is well-controlled with antiretroviral therapy; (4) persons who may be infected based upon these behaviors should be tested following exposure; (5) HIV testing information will be kept private; and (6) encouraging friends and family to get HIV tested is beneficial;" the team concluded.