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Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021….19.0% had a CDX (late diagnosis)
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There were 14,866 people newly diagnosed with HIV in NYS from 2016 to 2021, of which 19.0% had a CDX. Those with female sex at birth, history of injection drug use, or history of male-to-male sexual contact/history of injection drug use risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX.
Early diagnosis of HIV is 1 of the 3 pillars of the NYS Ending the Epidemic Initiative. Early diagnosis and linkage to care can prevent long-term complications and forward transmission of HIV. The benefits of active antiretroviral therapy can only be realized when people get tested and are aware of their status. It was anticipated that with the advent of active antiretroviral therapy in the mid-1990s, earlier testing would increase. However, this has not been the trend, especially in Europe where stagnant or even increasing rates of late diagnoses are observed.23
Without treatment, HIV progresses to AIDS in approximately 10 years.14 A concurrent diagnosis is defined as an HIV diagnosis that has progressed to stage 3 HIV (AIDS) within 30 days of diagnosis. Concurrent diagnoses are often a product of a lack of access to earlier testing opportunities. Previous research has noted that at a community level, poverty, lack of fuel, and lack of vehicle are related to concurrent diagnosis.15 At an individual level, older patients were more likely and White female patients were less likely to have a concurrent diagnosis.15 A study in New York City found that increasing testing coverage from 23% to 31% during 2003–2010 decreased the rate of concurrent diagnosis from 14.9 per 100,000 to 10.6 per 100,000 population.16
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