Combating HIV; Report Says Limited Testing in South Carolina Delaying Diagnoses

A study published on World AIDS Day in CDC's Morbidity and Mortality Weekly Report found that of more than 1,700 "late testers" diagnosed with HIV in South Carolina between 2001 and 2005, nearly three-quarters had visited a health care facility multiple times in the preceding years.

The study, led by Dr. Wayne Duffus of the South Carolina Department of Health and Environmental Control, showed that most "late testers" -- defined by CDC as people who progress to AIDS within a year of their initial HIV diagnosis -- had had up to five doctor visits within the previous year or longer before being tested for HIV.

Such missed chances for early diagnosis support CDC's new recommendations that patients ages 13 to 64 be tested as part of routine care in medical settings, providing they consent. "[The] recommendations… help answer a need for new approaches to reach the quarter of a million HIV-positive Americans who are unaware of their infection," said CDC spokesperson Jennifer Ruth.

In the South Carolina study, more than 40 percent of people testing HIV-positive developed AIDS within a year; almost 17 percent were diagnosed with AIDS within 30 days. Most visits in the study were to emergency rooms, where HIV testing is not common. Only a third of late testers in the study were injection drug users or men who had sex with men -- considered high-risk categories.

Health insurers have not yet said whether they will pay for testing, raising financial concerns. Another consideration is how to provide treatment for poor people once more testing yields more HIV diagnoses.

The study, "Missed Opportunities for Earlier Diagnosis of HIV Infection -- South Carolina, 1997-2005," was published in Morbidity and Mortality Weekly Report (2006;55(47):1269-1272).

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