Hu D J, Byers R, Fleming P L, Ward J W
Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Am J Prev Med. 1995 Mar-Apr;11(2):114-9.
To describe characteristics of persons with late (at or after death) acquired immunodeficiency syndrome (AIDS) diagnosis, we analyzed national surveillance data among all persons with AIDS diagnosed through December 1991 under the pre-1993 AIDS case definition and with a known date of death. Late diagnosis was present in 15.8% of 163,202 decreased persons with AIDS and in 15.3% of decreased men with AIDS, 20.6% of women, 12.1% of whites, 20.0% of blacks, 21.1% of Hispanics, 12.3% of men who have sex with men (MSM), 21.9% of injecting drug users (IDU), and 19.6% of persons exposed to human immunodeficiency virus (HIV) through heterosexual contact. When age, race/ethnicity, sex, geographic region, and transmission mode were included in logistic regression analyses, among adults/adolescents, late diagnosis was more likely among persons 40 years or older than among those 13-39 years old, among blacks and Hispanics than among whites, and among IDU and persons exposed to HIV through heterosexual contact than among MSM. Although children (less than 13 years of age) were more likely to have late diagnosis than adults and adolescents, late diagnoses among children did not differ significantly by race/ethnicity, sex, geographic region, or transmission mode. Late AIDS diagnosis, especially among ethnic minorities and IDU and their sex partners, may represent delays in HIV diagnosis and care. In addition to not receiving early clinical intervention, persons who are diagnosed later in the course of HIV disease represent missed opportunities for receiving prevention efforts such as education, counseling, and substance abuse treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
为描述晚期（死亡时或死亡后）获得性免疫缺陷综合征（艾滋病）确诊患者的特征，我们分析了1993年以前艾滋病病例定义下、截至1991年12月确诊且已知死亡日期的所有艾滋病患者的国家监测数据。在163202例已故艾滋病患者中，15.8%为晚期确诊；在已故男性艾滋病患者中，这一比例为15.3%，女性为20.6%，白人12.1%，黑人20.0%，西班牙裔21.1%，男男性行为者（MSM）12.3%，注射吸毒者（IDU）21.9%，通过异性接触感染人类免疫缺陷病毒（HIV）者19.6%。在逻辑回归分析中纳入年龄、种族/族裔、性别、地理区域和传播方式后，在成人/青少年中，40岁及以上者比13 - 39岁者更易出现晚期确诊，黑人和西班牙裔比白人更易出现，IDU以及通过异性接触感染HIV者比MSM更易出现。尽管儿童（13岁以下）比成人和青少年更易出现晚期确诊，但儿童中的晚期确诊在种族/族裔、性别、地理区域或传播方式方面无显著差异。艾滋病晚期确诊，尤其是在少数族裔、IDU及其性伴侣中，可能意味着HIV诊断和治疗的延迟。除了未获得早期临床干预外，在HIV疾病进程后期确诊的患者还意味着错失接受教育、咨询和药物滥用治疗等预防措施的机会。（摘要截选至250词）
