Factors associated with late HIV diagnosis

Aim. To assess the frequency of late HIV diagnosis among newly diagnosed HIV cases in 2019 and to determine associated risk factors.Materials and Methods. The study included data from 1073 adult patients who lived in the Tatarstan Republic and were first diagnosed with HIV infection in 2019. Criteria for late HIV diagnosis were the presence of stage 4 HIV-infection (AIDS) and/or < 200 CD4+ cells per mm3 at the time of diagnosis. The influence of various factors on the timeliness of diagnosis was carried out using binary logistic regression and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).Results. Late diagnosis was documented in 37.7% of HIV infection cases. Clinical examination was associated with late diagnosis in comparison with a preventive examination (aOR = 2.06; 95% CI = 1.40–3.02). The age of ≥ 50 years was associated with late diagnosis in comparison with 30−49 years age range (aOR = 2.18; 95% CI = 1.41–3.37). Vice versa, the age of < 30 years was associated with timely diagnosis as compared to 30−49 years age range (aOR 0.44; 95% CI = 0.30–0.68). Living in urban areas has been associated with late HIV diagnosis (aOR = 1.470; 95% CI = 1.002–2.153) in comparison with living in rural areas.Conclusion. The factors associated with the late HIV diagnosis were examination for clinical indications, age ≥ 50 years, and living in urban areas. For curbing the HIV epidemic, it is necessary to expand the HIV screening to all population groups, especially elderly.