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Estimated time from HIV infection to diagnosis and diagnosis to first viral suppression during 2014–2018
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11 01 2021
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Source: AIDS. 35(13):2181-2190
[PDF-189.52 KB]
Details:
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Alternative Title:AIDS
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Personal Author:
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Description:Objective:
To examine changes in the lengths of time from HIV infection to diagnosis (Infx-to-Dx) and from diagnosis to first viral suppression (Dx-to-VS), two periods during which HIV can be transmitted.
Design:
Data from the National HIV Surveillance System (NHSS) for persons who were aged ≥13 years at the time of HIV diagnosis during 2014–2018 and resided in one of 33 U.S. jurisdictions with complete laboratory reporting.
Methods:
The date of HIV infection was estimated based on a CD4-depletion model. Date of HIV diagnosis, and dates and results of first CD4 test and first viral suppression (<200 copies/mL) after diagnosis were reported to NHSS through December 2019. Trends for Infx-to-Dx and Dx-to-VS intervals were examined using estimated annual percentage change.
Results:
During 2014–2018, among persons aged ≥13 years, 133,413 HIV diagnoses occurred. The median length of infx-to-Dx interval shortened from 43 months (2014) to 40 months (2018), a 1.5% annual decrease (7.0% relative change over the 5-year period). The median length of Dx-to-VS interval shortened from 7 months (2014) to 4 months (2018), an 11.4% annual decrease (42.9% relative change over the 5-year period). Infx-to-Dx intervals shortened in only some subgroups, while Dx-to-VS intervals shortened in all groups by sex, transmission category, race/ethnicity, age, and CD4 count at diagnosis.
Conclusion:
The shortened Infx-to-Dx and Dx-to-VS intervals suggest progress in promoting HIV testing and earlier treatment; however, diagnosis delays continue to be substantial. Further shortening both intervals and eliminating disparities are needed to achieve Ending the HIV Epidemic goals.
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Source:
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Pubmed ID:34172670
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Pubmed Central ID:PMC9647140
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