HIV transmission: Patients diagnosed at advanced stages more likely to transmit it

Washington DC: A new research at the University of California has found that patients diagnosed late in the course of HIV infection are more likely to transmit HIV to others since they are not on treatment to suppress it and could be transmitting the disease without knowing they are doing so.

 

Further, these patients are at an increased risk of negative health outcomes such as premature death, increased risk of HIV transmission, and opportunistic infections such as Kaposi’s sarcoma, Pneumocystis carinii pneumonia and toxoplasmosis.

Lead researcher Brandon Brown and his team examined the prevalence and risk factors for county residents who have an AIDS diagnosis within 12 months of their first HIV-positive test.

“Although free confidential testing is available throughout Riverside County, more than 30 per cent of new HIV diagnoses qualified as late-to-test, that is, they received an AIDS diagnosis within 12 months of a seropositive HIV result,” Brown said.

“Earlier diagnosis is a critical component in preventing onward transmission of the virus and represents missed opportunities for treatment,” he added.

The researchers found:

An increased risk of late HIV testing among those who were between 45 and 64 years of age and the uninsured (this group is less likely to test).

An increased risk for late testing among Hispanics but not other racial/ethnic minorities (this is likely due to a larger proportion of Hispanics who participated in the study compared to other

racial/ethnic minorities).

A reduced risk among women and those who live in the eastern part of the county (this is due to extensive HIV prevention activities in this region) and

Those who were foreign born were more likely to be late testers (this is perhaps due to less access to healthcare).

The study used data from HIV surveillance and medical records to identify risk factors for late-testing.

The researchers identified factors associated with getting tested late and next will plan studies to intervene with those who were late to test.

“More outreach for HIV testing needs to be done with those who are uninsured, over 45 years of age, and foreign born,” Brown said.

“HIV testing is important for everyone, and most important if done early to extend life, to prevent transmission, and to save on medical costs. Universal testing, the gold standard, is not routinely practiced. We are working to change this,” he added.

The Centres for Disease Control and Prevention (CDC) recommends everyone between 13 and 64 get HIV testing as part of routine health care but this is not routinely practiced for several reasons.

These reasons can include discomfort in broaching the HIV testing topic by doctor and/or patient, other priorities at the patient visit, and belief that the patient is low risk for HIV.

The findings of the study appeared in the Medicine.