Delayed diagnosis of HIV infection in Victoria 1994 to 2006

Sexual Health ◽  
2009 ◽  
Vol 6 (2) ◽  
pp. 117 ◽  
Author(s):  
Chris Lemoh ◽  
Rebecca Guy ◽  
Keflemariam Yohannes ◽  
Jenny Lewis ◽  
Alan Street ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Delayed Diagnosis ◽  
Injecting Drug Use ◽  
Sexual History ◽  
Hiv Diagnosis ◽  
Male Homosexual ◽  
Hiv Test ◽  
High Prevalence ◽  
Epidemiological Characteristics

Background: The identification of factors associated with delayed diagnosis of HIV infection in Victoria, Australia was the aim of the present study. Methods: Demographic and epidemiological characteristics of cases notified to the Victorian HIV surveillance database between 1 January 1994 and 31 December 2006 were analysed. Delayed diagnosis was defined as: CD4 count below 200 cells mm−3 at HIV diagnosis or diagnosis of AIDS earlier than 3 months after HIV diagnosis. Results: Diagnosis of HIV was delayed in 627 (22.6%) of 2779 cases. Of these, 528 (84.2%) had either a high-risk exposure or were born in a high-prevalence country. The most common exposure was male homosexual contact in 64.3% of cases. Independent risk factors for delayed diagnosis were: older age at diagnosis (30–39 years odds ratio [OR] 2.15, ≥ 50 years OR 7.50, P < 0.001), exposure via routes other than male homosexual sex or injecting drug use (heterosexual sex OR 2.51, P < 0.001, unknown/other route OR 4.24, P < 0.001); birth in Southern/Eastern Europe (OR 2.54), South-east Asia (OR 2.70) or the Horn of Africa/North Africa (OR 3.71, P < 0.001), and male gender (OR 0.47 for females, P < 0.001). Conclusion: Delay in the diagnosis of HIV infection is common in Victoria, but potentially avoidable in the majority of cases. Most people with delayed diagnosis had a history of male homosexual contact, injecting drug use, birth in a high-prevalence country or sexual contact with such individuals. An accurate sexual history, together with knowledge of their country of birth, should identify most individuals who should be offered an HIV test.

Late diagnosis of HIV: A lookback on cases in North Cumbria

2019 ◽  
Vol 30 (11) ◽  
pp. 1124-1126
Author(s):  
B Khalifeh ◽  
M Phillips ◽  
E Barton
Keyword(s):  
Catchment Area ◽  
Late Diagnosis ◽  
Hiv Diagnosis ◽  
Missed Opportunities ◽  
Unexplained Weight Loss ◽  
Hiv Test ◽  
High Prevalence ◽  
Low Prevalence ◽  
Single Figure ◽  
Rural Catchment

Late diagnosis of HIV remains a threat to personal and public health – both increasing the morbidity and mortality of the person and also increasing the chance of unknowingly transmitting HIV. Many HIV testing initiatives, including those of the British HIV Association (BHIVA), focus on levels of high prevalence (greater than 2:1000). However, late diagnosis can be an issue in areas of low prevalence – areas which can be less densely populated and in some cases classified as rural. In our rural catchment area, late diagnosis is an issue with 67% diagnosed late in 2015 (which is skewed by the single figure diagnoses). This lookback examined the number of missed opportunities for HIV diagnosis over a seven-year period and found that where diagnoses were made late in the context of a person having previously presented for care, unexplained weight loss, blood dyscrasias and lymphadenopathy were the most common presentations that could have triggered a HIV test.

Injecting drug use and HIV infection in southwest China

AIDS ◽  
1994 ◽  
Vol 8 (8) ◽  
pp. 1141-1148 ◽  
Author(s):  
Xiwen Zheng ◽  
Chunqiao Tian ◽  
Kyung-Hee Choi ◽  
Jiapeng Zhang ◽  
Hehe Cheng ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Southwest China ◽  
Injecting Drug Use

Adolescents, sex and injecting drug use: Risks for HIV infection

AIDS Care ◽  
1990 ◽  
Vol 2 (2) ◽  
pp. 103-116 ◽  
Author(s):  
M. Barnard ◽  
N. McKeganey
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Injecting Drug Use

UK national audit of sexual health care for people with HIV infection: case-notes audit

2007 ◽  
Vol 18 (9) ◽  
pp. 639-642 ◽  
Author(s):  
Chris Carne ◽  
Hugo McClean ◽  
Paul Bunting ◽  
Ed Wilkins ◽  
Linda Tucker ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Hiv Infection ◽  
Sexual History ◽  
Hiv Diagnosis ◽  
Sexually Transmitted ◽  
Sexual Health Care ◽  
Outbreak Areas ◽  
Hepatitis B Testing ◽  
Syphilis Serology

The case-notes of 3210 patients with HIV infection were audited. A sexual history was documented within four weeks before or after initial HIV diagnosis in 69% of cases (regional range 45–84%), and in the six months before attendance during the audit interval in 34% (12–53%). An offer of tests for sexually transmitted infections was documented within four weeks before or after HIV diagnosis in 58% (30–83%), and in the prior six months in 28% (14–47%). Syphilis serology was offered in the previous three months to 45% (14–100%) of cases resident in syphilis outbreak areas and to 25% (7–62%) of other cases. Hepatitis B testing was performed for 98% (95–100%) of cases and for hepatitis C, for 91% (79–100%). Cervical cytology results in the past year were documented for 73% (43–94%) of eligible women. Considerable inter-regional variation in performance exists. Interventions are needed to improve the sexual health care of people with HIV infection.

scholarly journals Changing trends of HIV, syphilis, HCV infections and behavioural factors among female sex workers in Chongqing, China: findings from six serial surveillance surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036654
Author(s):  
Ling Hu ◽  
Guohui Wu ◽  
Rongrong Lu ◽  
Hua Zhu ◽  
Hongfang Qiu ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Condom Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Injecting Drug Use ◽  
Hcv Infection ◽  
Syphilis Infection ◽  
Changing Trends ◽  
Middle Tier

ObjectivesTo explore the prevalence and changing trends of HIV, syphilis, hepatitis C virus (HCV) infections and risk behaviours among female sex workers (FSWs) and to provide reference and theoretical basis for formulating targeted interventions.DesignSix consecutive cross-sectional surveys.SettingChongqing, China.ParticipantsFSWs were included if they (1) were aged ≥16 years, (2) provided commercial sex for money or goods during the previous month and (3) were willing to participate in the survey and could provide verbal informed consent. This study included 16 791 of 16 810 participants recruited between 2013 and 2018.Primary and secondary outcome measuresThe prevalence of HIV/syphilis/HCV infection.ResultsThe HIV and HCV prevalence among FSWs in Chongqing was stable during the study period, but the prevalence of syphilis had an increasing trend, particularly among low-tier and middle-tier FSWs. Improvements in HIV-related knowledge, condom use, injecting drug use and participation in HIV-related services were observed. However, no change was found in the prevalence of drug use. HIV infection was correlated with no condom use in the last commercial sex (adjusted OR (aOR) 3.48, 95% CI 1.90 to 6.37) and syphilis infection (aOR 4.88, 95% CI 1.95 to 12.18). Syphilis infection was correlated with inconsistent condom use (aOR 1.30, 95% CI 1.02 to 1.65), HIV infection (aOR 5.88, 95% CI 2.40 to 14.41), HCV infection (aOR 7.68, 95% CI 4.37 to 13.49) and sexually transmitted infection (STI) diagnosis in the past year (aOR 3.81, 95% CI 2.40 to 6.03). HCV infection was associated with injecting drug use (aOR 8.91, 95% CI 4.45 to 17.86) and syphilis infection (aOR 7.88, 95% CI 4.49 to 13.83).ConclusionsComprehensive interventions targeting FSWs, particularly low-tier and middle-tier FSWs, should be increasingly implemented to prevent and control HIV, syphilis and other STIs.

A new surveillance system for monitoring HIV infection in Victoria, Australia

Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 195 ◽  
Author(s):  
Rebecca Guy ◽  
Megan S. C. Lim ◽  
Yung-Hsuan J. Wang ◽  
Nicholas Medland ◽  
Jonathan Anderson ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surveillance System ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Hiv Diagnosis ◽  
Hiv Test

Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.

HIV infection in psychiatric patients: An unlinked anonymous study

1997 ◽  
Vol 170 (2) ◽  
pp. 181-185 ◽  
Author(s):  
José L. Ayuso-Mateos ◽  
Francisco Montañés ◽  
Ismael Lastra ◽  
Juan J. Picazo De La Garza ◽  
José L. Ayuso-Gutiérrez
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Psychiatric Patients ◽  
Risk Behaviour ◽  
Injecting Drug Use ◽  
Antibody Testing ◽  
Increased Risk ◽  
The Us ◽  
History Of ◽  
Blood Specimens

BackgroundRecent surveys suggest that psychiatric patients are at increased risk of being infected with HIV, although very little information is available concerning the seroprevalence of HIV infection among this population outside the US. The aim of this study is to determine the seroprevalence of HIV-I among patients admitted to a psychiatric in-patient unit and to gather linked anonymous risk-factor information.MethodAn unlinked serosurvey was made, using HIV-1 antibody testing of remnant blood specimens collected for routine medical purposes, of patients consecutively admitted to an acute psychiatric unit in Madrid.ResultsBlood was obtained from 390 of the 477 eligible patients (81.8%). The prevalence of HIV was 5.1% (20/390). Patients aged between 18 and 39 accounted for 63.4% of the admissions and 75% of the positive results. Of the 29 patients who presented with injecting drug use, 14 were HIV-infected (48.3%; 95% CI 29.4 67.5). Of the 51 patients for whom any risk behaviour was noted on the admission chart, 18 were HIV-infected (35.3%; 95% CI 22.4 49.9).ConclusionsThis study demonstrates that there is a substantial prevalence of HIV infection in psychiatric patients admitted to an acute in-patient unit. History of injecting drug use was strongly associated with seropositivity. Clinicians recognised risk factors for HIV infection in the majority of the HIV-infected cases.

Global overview of injecting drug use and HIV infection among injecting drug users

AIDS ◽  
2004 ◽  
Vol 18 (17) ◽  
pp. 2295-2303 ◽  
Author(s):  
Carmen Aceijas ◽  
Gerry V Stimson ◽  
Matthew Hickman ◽  
Tim Rhodes
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Drug Users ◽  
Injecting Drug Users ◽  
Injecting Drug Use

scholarly journals Disproportionate and increasing burden of HIV infection among men who have sex with men in Slovenia: surveillance data for 1999-2008

2009 ◽  
Vol 14 (47) ◽  
Author(s):  
I Klavs ◽  
N Bergant ◽  
Z Kastelic ◽  
A Lamut ◽  
T Kustec
Keyword(s):  
Hiv Infection ◽  
Mandatory Reporting ◽  
Infection Prevalence ◽  
Outpatient Services ◽  
Hiv Diagnosis ◽  
Male Clients ◽  
Hiv Test ◽  
Positive Prevention ◽  
Sex With Men ◽  
Sentinel Population

The report presents data on HIV infection among men who have sex with men (MSM) in Slovenia during 1999-2008. HIV surveillance was based on universal mandatory reporting of HIV/AIDS cases, monitoring HIV infection prevalence among sentinel populations of MSM and STI patients and selected behaviour indicators in a sentinel population of MSM. Among 48 newly diagnosed HIV cases reported for 2008, 34 were MSM. Since 1999, the annual reported rate of HIV diagnoses in MSM rose from 7.1 to 46.8 per million men aged 15-64 years (an increase of more than six times). During 1999-2008, the proportion of MSM diagnosed with AIDS within three months of HIV diagnosis declined from 60% to 21%, however, the corresponding rate per million men aged 15-64 increased from 4.3 to 9.6. During 1999-2008, HIV prevalence among male clients of STI outpatient services tested for syphilis (including a substantial proportion of MSM) increased from 0% to 3.4%, and it remained below 5% in a sentinel population of MSM in Ljubljana. In the same sentinel population of MSM, the proportion reporting HIV test last year increased from 29% in 2003 to 38% in 2008 while the proportion reporting condom use at last anal intercourse decreased from 81% in 2004 to 66% in 2008. The burden of HIV among MSM in Slovenia is disproportionately high and increasing fast. Promotion of safer sexual behaviour and HIV testing among MSM as well as positive prevention among MSM with diagnosed HIV infection are urgently needed.

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