Nav: Home

Patients diagnosed late with HIV infection are more likely to transmit HIV to others

October 06, 2016

RIVERSIDE, Calif. - An estimated 1.2 million people live with HIV in the United States, with nearly 13 percent being unaware of their infection. New research by Brandon Brown in the School of Medicine at the University of California, Riverside and colleagues 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 the viral load and could be transmitting HIV 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.

The research was conducted in Riverside County, Calif., the sixth most HIV/AIDS-impacted county in the state. Brown, an assistant professor in the Center for Healthy Communities, and his colleagues 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 percent 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."

Study results appear in the September 2016 issue of Medicine.

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 in Riverside County, 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, including Get Tested Coachella Valley, 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."

The Centers 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.

Brown was joined in the study by Aaron T. Gardner and Rachaline Napier at Riverside University Health System Public Health.

Their analysis included a total of 1,385 Riverside County residents with an HIV diagnosis. The researchers used data (January 2009 to December 2014) from the Enhanced HIV/AIDS Reporting System maintained by the Office of AIDS, California Department of Public Health.

More than two-thirds of the residents in the study were male (88 percent), born in the US (72 percent), and either white or Hispanic (48 percent and 36 percent, respectively). Mean age was 39.5 years. Forty percent of the participants were from western Riverside County. The most common reported mode of HIV transmission was through men who have sex with men (70 percent).

"Our analysis provides important insights," Brown said. "We need to expand testing services, particularly in places with a high density of uninsured and/or Hispanic residents. Routine testing, recommended by the CDC, is cost effective, and should be promoted. Such testing can significantly increase the time period between an HIV-positive diagnosis to an eventual AIDS diagnosis, and can lead to longer and healthier lives for those infected with HIV."
-end-
The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment has exceeded 21,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual statewide economic impact of more than $1 billion. A broadcast studio with fiber cable to the AT&T Hollywood hub is available for live or taped interviews. UCR also has ISDN for radio interviews. To learn more, call (951) UCR-NEWS.

University of California - Riverside

Related Hiv Articles:

Defective HIV proviruses reduce effective immune system response, interfere with HIV cure
A new study finds defective HIV proviruses, long thought to be harmless, produce viral proteins and distract the immune system from killing intact proviruses needed to reduce the HIV reservoir and cure HIV.
1 in 7 people living with HIV in the EU/EEA are not aware of their HIV status
Almost 30,000 newly diagnosed HIV infections were reported by the 31 European Union and European Economic Area (EU/EEA) countries in 2015, according to data published today by ECDC and the WHO Regional Office for Europe.
Smoking may shorten the lifespan of people living with HIV more than HIV itself
A new study led by researchers at Massachusetts General Hospital finds that cigarette smoking substantially reduces the lifespan of people living with HIV in the US, potentially even more than HIV itself.
For smokers with HIV, smoking may now be more harmful than HIV itself
HIV-positive individuals who smoke cigarettes may be more likely to die from smoking-related disease than the infection itself, according to a new study published in the Journal of Infectious Diseases.
Patients diagnosed late with HIV infection are more likely to transmit HIV to others
An estimated 1.2 million people live with HIV in the United States, with nearly 13 percent being unaware of their infection.
More Hiv News and Hiv Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...