Epidemiological assessment of factors associated with late diagnosis of HIV infection

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Background. Late diagnosis of human immunodeficiency virus (HIV) infection contributes to its spread and becomes an obstacle to achieving the goal of early treatment.

Aim. To conduct an epidemiological analysis of factors associated with late diagnosis of HIV infection.

Material and methods. The study included data from 348 patients over 18 years of age living in Kazan, who were diagnosed with HIV infection for the first time in 2019. The proportion of patients with late diagnosis of HIV infection was determined. The criteria for late diagnosis were the level of CD4+-lymphocytes less than 200 cells/mm3 and/or the presence of 4 HIV stage (stage of secondary diseases) at the time of diagnosis. The assessment of the influence of probable factors on the timeliness of diagnosis was carried out using binary logistic regression. The regression model included data from 307 people who managed to determine the timeliness of diagnosis. For each factor, odds ratios were calculated (unadjusted — based on the results of univariate analysis, adjusted — based on the results of multivariate analysis), as well as their 95% confidence intervals.

Results. Late diagnosis of HIV infection was noted in 32.6% of cases. Examination for clinical indications was associated with late diagnosis in comparison with examination for preventive purposes (adjusted odds ratio 2.427, 95% confidence interval 1.184–4.973). The age of 50 years and older was associated with late diagnosis compared with patients 30–49 years of age (adjusted odds ratio 3.348, 95% confidence interval 1.542–7.265).The chances of late diagnosis under the age of 30 years are 5 times lower than in the 30–49 year old group (adjusted odds ratio 0.200, 95% confidence interval 0.072–0.556). The odds of late diagnosis are significantly higher among people who become infected through parenteral transmission through injecting drug use compared to those who become infected through sexual (heterosexual) transmission (adjusted odds ratio 2.012, 95% confidence interval 1.042–3.885).

Conclusion. In order to control the spread of HIV infection in the population, it is necessary to increase the coverage of HIV screening testing for all population groups, especially the older age group and injecting drug users.

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About the authors

Gulshat R. Khasanova

Kazan State Medical University; Republican Center for the Prevention and Control of AIDS and Infectious Diseases

Email: gulshatra@mail.ru
ORCID iD: 0000-0002-1733-2576
SPIN-code: 6704-2840
Scopus Author ID: 6507469219

M.D., D. Sci. (Med.), Prof., Head, Depart. of Epidemiology and Evidence-Based Medicine

Russian Federation, Kazan, Russia; Kazan, Russia

Saida T. Agliullina

Kazan State Medical University

Author for correspondence.
Email: saida.agliullina@kazangmu.ru
ORCID iD: 0000-0003-4733-6911
SPIN-code: 2079-1833
Scopus Author ID: 57200421742

M.D., Cand. Sci. (Med.), Senior Lecturer, Depart. of Epidemiology and EBM

Russian Federation, Kazan, Russia

Lidia A. Kruykova

Kazan State Medical University

Email: liddija@yandex.ru
ORCID iD: 0000-0001-9713-3245

M.D., Resident, Depart. of Epidemiology and Evidence-Based Medicine

Russian Federation, Kazan, Russia

Guliya R. Gilmutdinova

Center for Hygiene and Epidemiology in the Republic of Tatarstan

Email: almieva14@mail.ru
ORCID iD: 0000-0003-0257-8466

M.D., Epidemiologist

Russian Federation, Kazan, Russia

Firaya I. Nagimova

Republican Center for the Prevention and Control of AIDS and Infectious Diseases

Email: nagimova@list.ru
ORCID iD: 0000-0002-5703-6712
Scopus Author ID: 55888997900

M.D., Cand. Sci. (Med.), Deputy Chief Doctor

Russian Federation, Kazan, Russia

Niyaz I. Galiullin

Republican Center for the Prevention and Control of AIDS and Infectious Diseases

Email: centre_spid@tatar.ru
ORCID iD: 0000-0002-2665-6695

M.D., Cand. Sci. (Med.), Chief Doctor

Russian Federation, Kazan, Russia


  1. Global HIV & AIDS statistics — Fact sheet. UNAIDS 2021 epidemiological estimates. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf (access date: 08.11.2021).
  2. Information from the Federal Scientific and Methodological Center for the Prevention and Control of AIDS of the Central Research Institute of Epidemiology of Rospotrebnadzor “HIV infection in the Russian Federation for December 31, 2020”. http://www.hivrussia.info/wp-content/uploads/2021/03/VICH-infektsiya-v-Rossijskoj-Federatsii-na-31.12.2020-.pdf (access date: 21.09.2021). (In Russ.)
  3. Agliullina ST, Mukharyamova LM, Khasanova GR. VICH-infektsiya u zhenshchin: sovremennye tendentsii epidemicheskogo protsessa. Monografiya. (HIV infection in women: current trends in the epidemic process. Monography.) Kazan: ID “MeDDok”; 2019. 152 p. (In Russ.)
  4. Jiwatram-Negrón T, El-Bassel N. Systematic review of couple-based HIV intervention and prevention studies: Advantages, gaps, and future directions. AIDS Behav. 2014;18(10):1864–1887. doi: 10.1007/s10461-014-0827-7.
  5. Muessig KE, Cohen MS. Advances in HIV prevention for serodiscordant couples. Curr HIV/AIDS Rep. 2014;11(4):434–46. doi: 10.1007/s11904-014-0225-9.
  6. Knight R, Small W, Thomson K, Gilbert M, Shoveller J. Implementation challenges and opportunities for HIV Treatment as Prevention (TasP) among young men in Vancouver, Canada: a qualitative study. BMC Public Health. 2016;16(1):262. doi: 10.1186/s12889-016-2943-y.
  7. Liu P, Tang Z, Lan G, Zhu Q, Chen H, You Y, Yang X, Liang S, Chen Y, Xing H, Liao L, Feng Y, Shen Z, Ruan Y, Shao Y. Early antiretroviral therapy on reducing HIV transmission in China: strengths, weaknesses and next focus of the program. Sci Rep. 2018;8(1):3431. doi: 10.1038/s41598-018-21791-2.
  8. Fast-Track: accelerating action to end the AIDS epidemic by 2030. https://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Understanding_FastTrack_en.pdf (access date: 29.12.2021).
  9. Clinical guidelines “HIV infection in adults”. Russian Fede¬ration Ministry of Health; 2020. http://www.consultant.ru/document/cons_doc_LAW_377651/8efd5f17af55cb35a770f73937590c642437b7eb/ (access date: 10.10.2021). (In Russ.)
  10. Global AIDS Monitoring 2019. UNAIDS 2018, Guidance Indicators for monitoring the 2016 Political Declaration on Ending AIDS. https://www.medbox.org/document/global-aids-monitoring-2019#GO (access date: 08.11.2021).
  11. Bath RE, Emmett L, Verlander NQ, Reacher M. Risk factors for late HIV diagnosis in the East of England: Evidence from national surveillance data and policy implications. Int J STD AIDS. 2019;30(1):37–44. doi: 10.1177/0956462418793327.
  12. Palacios-Baena ZR, Martín-Ortega M, Ríos-Villegas MJ. Profile of new HIV diagnoses and risk factors associated with late diagnosis in a specialized outpatient clinic during the 2014–2018 period. Med Clin (Barc). 2020;155(11):482–487. doi: 10.1016/j.medcli.2020.01.035.
  13. Muelas Fernandez M, Rojas Lievano JF, Perez Vidal R, Flor Perez A, Tapiz Reula A, Mallolas Masferrer J. Prevalencia de diagnóstico tardío en infección por VIH. Med Clínica. 2020;155(9):388–391. doi: 10.1016/j.medcli.2020.01.029.
  14. Gargallo-Bernad C, Sangrós-González FJ, Arazo-Garcés P, Martínez-Álvarez R, Malo-Aznar C, Gargallo-Bernad A, Ballester-Luna A, Cabrero-Pascual LE, Gil-Orna P, Abadía-Gallego VJ, Torres-Peña I, Ordiz-Suárez H. Oportunidades perdidas en el diagnóstico de la infección por el virus de inmunodeficiencia humana en la Comunidad de Aragón. Importancia del diagnóstico tardío. Enfermedades Infecc Microbiol Clínica. 2019;37(2):100–108. doi: 10.1016/j.eimc.2018.03.007.
  15. Dai S-Y, Liu J-J, Fan Y-G, Shan G-S, Zhang H-B, Li M-Q, Ye D-Q. Prevalence and factors associated with late HIV diagnosis: Prevalence, factors, and late HIV dia¬gnosis. J Med Virol. 2015;87(6):970–977. doi: 10.1002/jmv.24066.
  16. Mohammadi Y, Mirzaei M, Shirmohammadi-Khorram N, Farhadian M. Identifying risk factors for late HIV diagnosis and survival analysis of people living with HIV/AIDS in Iran (1987–2016). BMC Infect Dis. 2021;21(1):390. doi: 10.1186/s12879-021-06100-z.
  17. Gullón A, Verdejo J, de Miguel R, Gómez A, Sanz J. Factors associated with late diagnosis of HIV infection and missed opportunities for earlier testing. AIDS Care. 2016;28(10):1296–300. doi: 10.1080/09540121.2016.1178700.
  18. Wilton J, Light L, Gardner S, Rachlis B, Conway T, Cooper C, Cupido P, Kendall CE, Loutfy M, ¬McGee F, Murray J, Lush J, Rachlis A, Wobeser W, Bacon J, ¬Kroch AE, Gilbert M, Rourke SB, Burchell AN; Ontario HIV Treatment Network (OHTN) Cohort Study Team. Late diagnosis, delayed presentation and late presentation among persons enrolled in a clinical HIV cohort in Ontario, Canada (1999–2013). HIV Med. 2019;20(2):110–120. doi: 10.1111/hiv.12686.
  19. Noble G, Okpo E, Tonna I, Fielding S. Factors associated with late HIV diagnosis in North-East Scotland: A six-year retrospective study. Public Health. 2016;139:36–43. doi: 10.1016/j.puhe.2016.06.007.
  20. Hu X, Liang B, Zhou C, Jiang J, Huang J, Ning C, Liu J, Zhou B, Zang N, Lai J, Chen R, Liao Y, Pan P, Liu X, Lan G, Pang X, Ye L, Shen Z, Liang H. HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: A large-scale cross-sectional study. AIDS Res Ther. 2019;16(1):6. doi: 10.1186/s12981-019-0221-7.
  21. Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, Maddox LM. Individual and neighborhood determinants of late HIV diagnosis among latinos, Florida, 2007–2011. J Immigr Minor Health. 2017;19(4):825–834. doi: 10.1007/s10903-016-0422-2.
  22. Bonjour MA, Montagne M, Zambrano M, Molina G, Lippuner C, Wadskier FG, Castrillo M, Incani RN, Tami A. Determinants of late disease-stage presentation at diagnosis of HIV infection in Venezuela: A case-case comparison. AIDS Res Ther. 2008;5(1):6. doi: 10.1186/1742-6405-5-6.
  23. Yombi JC, Jonckheere S, Vincent A, Wilmes D, Vandercam B, Belkhir L. Late presentation for human immunodeficiency virus HIV diagnosis results of a Belgian single centre. Acta Clin Belg. 2014;69(1):33–39. doi: 10.1179/0001551213Z.00000000014.
  24. Musumari PM, Techasrivichien T, Srithanaviboonchai K, Tangmunkongvorakul A, Ono-Kihara M, Kihara M. Factors associated with HIV testing and intention to test for HIV among the general population of Nonthaburi Province, Thailand. PLOS One. 2020;15(8):e0237393.
  25. De Anda S, Njoroge A, Njuguna I, Dunbar MD, Abuna F, Macharia P, Betz B, Cherutich P, Bukusi D, Farquhar C, Katz DA. Predictors of first-time and repeat HIV testing among HIV-positive individuals in Kenya. J Acquir Immune Defic Syndr. 2020;85(4):399–407. doi: 10.1097/QAI.0000000000002469.
  26. Horino T, Sato F, Kato T, Hosaka Y, Shimizu A, Kawano S, Hoshina T, Nakaharai K, Nakazawa Y, Yoshikawa K, Yoshida M, Hori S. Associations of HIV testing and late diagnosis at a Japanese university hospital. Clinics (Sao Paulo). 2016;71(2):73–77. doi: 10.6061/clinics/2016(02)04.
  27. Op de Coul ELM, van Sighem A, Brinkman K, van Benthem BH, van der Ende ME, Geerlings S, Reiss P, ATHENA National Observational HIV Cohort. Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996–2014: results from a national observational cohort. BMJ Open. 2016;6(1):e009688. doi: 10.1136/bmjopen-2015-009688.

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