P82 Factors associated with delayed diagnosis in HIV late presenters

Abstract

Background/introduction Despite presenting indicator conditions, HIV diagnoses are often delayed resulting in higher mortality and morbidity. Aim(s)/objectives To review the rate of late HIV diagnosis locally and identify factors associated with delayed diagnosis. Methods Retrospective GUM and hospital case note review of all 31 newly diagnosed HIV patients attending the Norwich GUM clinic in 2013. Results 12/31 (38%) were late presenters with CD4 count persistently below 350 cells/mm 3 . At diagnosis 3/12 had no symptoms or indicator conditions; 2/12 had symptoms that were immediately acted upon; 7/12 had indicators illnesses not acted upon in a timely fashion hence the diagnoses were delayed from between 2 months to 2 years. Of these 7 delayed diagnoses 2 presented to GUM and declined testing initially although they were men who had sex with men (MSM). 5/7 presented as acute admissions; 3 were MSM (2 bisexual), 1 heterosexual male and 1 female. All of the 5 patients presenting with acute admission had medical associations; one was a nurse, 4 had immediate family members or a partner who was a nurse, doctor or pharmacist. The mean age of the male patients who were diagnosed in hospital was 65 years (range 52–80 years). Discussion/conclusion HIV testing may be less likely to be undertaken for older inpatients and those with medical associations.