Late HIV Testing in a Cohort of HIV-Infected Patients in Puerto Rico

Late HIV testing (LT), defined as receiving an AIDS diagnosis within a year of one's first positive HIV test, is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. 

• From 2000 to 2011, 47% of eligible patients were late testers, with lower median CD4 counts (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL) than non-LT patients. 
• LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrollment and past history of IDU significantly increased LT odds, whereas having a history of amphetamine use decreased LT odds. 
• When the data were stratified by mode of transmission, it became apparent that only the category men who have sex with men (MSM) saw a significant reduction in the proportion of LT, falling from 67% in 2000 to 33% in 2011.

These results suggest a gap in early HIV detection in Puerto Rico, a gap that decreased only among MSM. An evaluation of the manner in which current HIV-testing guidelines are implemented on the island is needed.

Via: http://ht.ly/SdbLo 

By: Tossas-Milligan KY1, Hunter-Mellado RF2, Mayor AM2, Fernández-Santos DM2, Dworkin MS1.

• 1Department of Medicine, University of California, San Francisco, California, USA.
• 2Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
• 3STD Prevention and Control Services, Department of Public Health, San Francisco, California, USA.