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Late Diagnosis of HIV Infection in Metropolitan Areas of the United States and Puerto Rico

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Abstract

The majority of persons infected with HIV live in large metropolitan areas and many such areas have implemented intensified HIV testing programs. A national indicator of HIV testing outcomes is late diagnosis of HIV infection (stage 3, AIDS). Based on National HIV Surveillance System data, 23.3 % of persons with HIV diagnosed in 2012 had a late diagnosis in large MSAs, 26.3 % in smaller MSAs, and 29.6 % in non-metropolitan areas. In the 105 large MSAs, the percentage diagnosed late ranged from 13.2 to 47.4 %. During 2003–2012, the percentage diagnosed late decreased in large MSAs (32.2–23.3 %), with significant decreases in 41 of 105 MSAs overall and among men who have sex with men. Sustained testing efforts may help to continue the decreasing trend in late-stage HIV diagnosis and provide opportunities for early care and treatment and potential reduction in HIV transmission.

Resumen

La mayoría de las personas infectadas con el VIH viven en grandes áreas metropolitanas y muchas de esas áreas han implementado programas intensivos de pruebas de VIH. Un indicador nacional del resultado de las actividades de pruebas de VIH es el diagnóstico tardío de la infección por VIH (clasificación 3, SIDA). Basado en datos del Sistema Nacional de Vigilancia de VIH, el 23.3 % de las personas con VIH diagnosticadas en 2012 en áreas estadísticas metropolitanas (MSA por sus siglas en inglés) grandes, tuvo un diagnóstico tardío, el 26.3 % en las MSA más pequeñas, y 29.6 % en las áreas no metropolitanas. En las 105 MSA grandes, el porcentaje de diagnósticos tardíos oscilo entre 13.2 % y 47.4 %. Del 2003 al 2012, el porcentaje de diagnósticos tardíos disminuyó en las MSA grandes (del 32.3 % al 23.3 %), con una disminución significativa en 41 de las 105 MSA grandes y entre hombres que tienen sexo con hombres. Los esfuerzos continuos en proveer pruebas de VIH pueden ayudar a continuar la tendencia decreciente de diagnósticos tardíos del VIH, y proporcionar oportunidades para la atención y tratamiento oportuno, y la reducción potencial en la transmisión del VIH.

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The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, E-47, Atlanta, GA, 30329-4027, USA

    H. Irene Hall & Lorena Espinoza

  2. ICF International, Atlanta, GA, USA

    Tian Tang

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  1. H. Irene Hall
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  2. Tian Tang
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  3. Lorena Espinoza
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Correspondence to H. Irene Hall.

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Hall, H.I., Tang, T. & Espinoza, L. Late Diagnosis of HIV Infection in Metropolitan Areas of the United States and Puerto Rico. AIDS Behav 20, 967–972 (2016). https://doi.org/10.1007/s10461-015-1241-5

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