Late diagnosis of HIV: could this be avoided?

Many patients with HIV infection present at a late stage of disease. Late diagnosis is associated with increased morbidity and mortality. One strategy to encourage earlier HIV diagnosis is the promotion of HIV testing outside of a specialist HIV setting. This study aimed to determine whether the diagnosis of HIV could be made sooner by non-HIV specialists consulting HIV-positive patients in the year preceding diagnosis. A case note review of all newly diagnosed HIV-positive patients seen over a 12-month period ending in September 2006, was performed to analyse whether patients had consulted a doctor in the year prior to diagnosis, whether they were offered HIV testing and whether they had symptoms or risk factors suggesting HIV infection. Fifty-one newly diagnosed HIV-positive patients were seen during the study period. Twenty-nine of these patients had consulted a doctor in the year prior to diagnosis. Of these, 10 were offered HIV testing and 19 were not. All patients who were not offered HIV testing had risk factors for-, or symptoms of HIV infection. The majority of newly diagnosed HIV patients had consulted a doctor in the year prior to diagnosis. Most were not offered HIV testing despite having risk factors for HIV infection. HIV diagnosis may have been made earlier by testing for HIV outside of a specialist setting.