Trend and Factors of Late HIV Diagnosis Among HIV Patients Diagnosed from 2008 to 2012 in Kunming, China

Highly Active Antiretroviral Therapy (HAART) has dramatically improved the prognosis of HIV infection. For HAART to have the desired effect, however, HIV infections must diagnosed early. Early HIV testing can promote the initiation of safer behaviors in HIV-infected individuals that lessen transmission risk to contacts. It also enables people to initiate antiretroviral therapy when indicated. The objectives of this study were to: 1) identify factors associated with late HIV diagnosis among HIV-infected patients diagnosed from 2008 to 2012 in Kunming, Yunnan Province, China; 2) describe the trend of late HIV diagnosis over time in Kunming. A cross-sectional study was conducted based on secondary data extracted from the Chinese antiretroviral electronic database. HIV-infected patients who had their HIV diagnoses between 2008 and 2012 and who entered care within one year of their HIV diagnosis were included in the analysis. Late HIV diagnosis was defined as a person who progressed to a CD4+ cell count (less than 200 cells/µL) or to an AIDS-defining clinical event diagnosis within 12 months of the date of HIV diagnosis. Independent variables included age at HIV diagnosis, gender, transmission mode, area of residence, average income level, and GDP per capita. Log binomial regression models were conducted to identify factors associated with late HIV diagnosis and to describe linear trends of late HIV diagnosis over time. Age at HIV diagnosis and gender were independent predictors of late HIV diagnosis among the study participants. The relative prevalence was 1.29 (95%CI: 1.11, 1.49) times higher among individuals aged 28-38 compared with those aged 18-28, and PR increased as age increased. Men had 12% (95%CI: 1.04, 1.21) higher prevalence compared with women after controlling for relevant covariates. The stratified analysis showed female intravenous drug users (IDUs) had 27% (95%CI: 1.11, 1.45) higher prevalence compared with heterosexual women but this association was not significant among IDU men. This study indicates men, older adults, and female IDUs were at greater risk for late HIV diagnosis among HIV-infected patients in Kunming, Yunnan Province, China. Current interventions targeting young students and older adults are effective, but more intervention strategies should be developed targeting at men and female IDUs to promote early HIV testing among them.