Late Presentation of HIV Infection: Prevalence, Trends, and the Role of HIV Testing Strategies in Guangzhou, China, 2008–2013

Weibin Cheng,Huifang Xu,Thitikarn May Tangthanasup,Faju Qin,Fei Zhong,Weiming Tang,Zhigang Han

doi:10.1155/2016/1631878

Abstract

Background. The prevalence, trends, and the role of different HIV testing strategies in late presentation of HIV infection in China were unknown. Methods. Data of newly reported HIV cases in Guangzhou between 2008 and 2013 was analyzed to examine the prevalence, trends, and characteristics of late presentation of HIV infection by three types of HIV testing strategies. Results. Overall, 53.2% (1412/2653) and 27.3% (724/2653) met the criteria of late presentation and presentation with advanced HIV disease. The overall trend of late presentation of HIV infection within the study period was declining. Late presentation was 62.9% in 2008 and dropped to 43.3% in 2013 (P < 0.001); presentation with advanced HIV disease was 40.3% in 2008 and dropped to 15.2% in 2013 (P < 0.001). Of the three testing strategies, PITC presented higher odds of both late presentation [AOR (95% CI): PITC versus VCT: 1.37 (1.09, 1.73); PITC versus MHT: 3.09 (2.16, 4.42)] and presentation with advanced HIV disease [AOR (95% CI): PITC versus VCT: 1.65 (1.29, 2.11); PITC versus MHT: 13.14 (8.47, 20.39)]. Conclusions. Although the late presentation of HIV infection was declining, it was still high in Guangzhou. The worse situation among PITC cases urges the policy adjustment in medical settings to increase early HIV diagnosis.

Highlights

The prevalence, trends, and the role of different Human immunodeficiency virus (HIV) testing strategies in late presentation of HIV infection in China were unknown
We found that half of the HIV newly diagnosed cases showed late presentation of HIV infection
Results showing a high proportion of late presentation of HIV infection among provider-initiated testing and counseling (PITC) cases urged the need for improving the capacity of early case detection in medical settings

Summary

Background

In October 2009, the European Late Presenter Consensus working group reached a consensus definition of late presentation of HIV infection [1]. A number of studies documented that late presentation of HIV infection is generally more common among marginalized individuals (i.e., ethnic minorities, drug users, and immigrants), people with low perceived risk of HIV infection (e.g., the elderly and heterosexuals), and those of low socioeconomic status (e.g., lower educational attainment) [14, 16,17,18,19,20,21,22,23,24]. Given the clinical and public health benefits of early HIV diagnosis on timely antiretroviral therapy (ART) initiation, it is imperative to understand the situation of late presentation of HIV infection in China and to provide evidence on whichever strategies could facilitate early diagnosis of HIV infection. By analyzing the HIV case report data in Guangzhou in 2008 to 2013 that was extracted from the Chinese HIV/AIDS Comprehensive Response Information Management System (CRIMS) [28], we conducted this study to examine the prevalence and trend of late presentation of HIV infection and to explore the role of different testing strategies in late presentation of HIV infection

Methods

Results

Discussion