Parisi Christina E, Canidate Shantrel S, Kwara Awewura, Li Zhigang, Zhou Zhi, Cohen Colby, Cook Robert L, Chichetto Natalie
Department of Epidemiology, University of Florida, Gainesville, FL, USA.
Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
AIDS Care. 2025 Jul;37(7):1131-1139. doi: 10.1080/09540121.2025.2484299. Epub 2025 Apr 1.
Different definitions of late HIV diagnosis are used to represent people diagnosed at an advanced stage of their illness. How well varying definitions represent those at risk for poor outcomes is unclear. Our aim was to examine proportions of late, delayed and timely HIV diagnoses in Florida and identify factors associated with diagnosis status. Using the first laboratory test in the Enhanced HIV/AIDS Reporting System, we determined annual proportions of late (CD4 < 200 cells/μL), delayed (200 ≤ CD4 < 350 cells/μL) and timely (CD4 ≥ 350 cells/μL) diagnoses in Florida between 2015 and 2021 and assessed characteristics associated with diagnosis status using multinomial logistic regression models. Among 30,411 individuals (20% female, 39% non-Hispanic Black, 34% Hispanic, mean age 37.1 years), 22% had a late and 17% had a delayed diagnosis. Non-Hispanic Black race, older age, and diagnosis at an inpatient facility were associated with greater odds of having a late or delayed diagnosis compared with having a timely diagnosis. There was no change in the prevalence of late, delayed, and timely diagnoses each year during the study period. Nearly 40% of HIV diagnoses in Florida were late or delayed. Given those with late and delayed diagnoses were similar, strategies to improve timeliness of diagnosis among these groups are needed.
不同的晚期艾滋病毒诊断定义用于代表在疾病晚期被诊断出的人群。不同定义在多大程度上代表了预后不良风险人群尚不清楚。我们的目的是研究佛罗里达州晚期、延迟和及时艾滋病毒诊断的比例,并确定与诊断状态相关的因素。利用强化艾滋病毒/艾滋病报告系统中的首次实验室检测结果,我们确定了2015年至2021年佛罗里达州晚期(CD4<200个细胞/μL)、延迟(200≤CD4<350个细胞/μL)和及时(CD4≥350个细胞/μL)诊断的年度比例,并使用多项逻辑回归模型评估与诊断状态相关的特征。在30411名个体中(20%为女性,39%为非西班牙裔黑人,34%为西班牙裔,平均年龄37.1岁),22%的人诊断为晚期,17%的人诊断为延迟。与及时诊断相比,非西班牙裔黑人种族、年龄较大以及在住院机构诊断与晚期或延迟诊断的几率更高相关。在研究期间,每年晚期、延迟和及时诊断的患病率没有变化。佛罗里达州近40%的艾滋病毒诊断为晚期或延迟。鉴于晚期和延迟诊断的人群相似,需要采取策略提高这些人群的诊断及时性。