Delayed presentation and late testing for HIV: demographic and behavioral risk factors in a multicenter study in Italy

J Acquir Immune Defic Syndr. 2004 Aug 1;36(4):951-9. doi: 10.1097/00126334-200408010-00009.


Ensuring timely access to care for persons with HIV is an important public health goal. To identify factors associated with delayed presentation to medical care after testing HIV-positive or with late HIV testing, we studied 968 patients at their first HIV care visit, enrolled in a multicenter study in Italy from 1997-2000. Patients completed a questionnaire on HIV-testing history, sexual behavior, and drug use behavior. Delayed presenters were patients with >6 months between their first HIV-positive test and presentation for HIV care; late testers were patients with CD4 count < 200 /mm or clinically defined AIDS at their first HIV-positive test. Among the study patients, 255 (26.3%) were delayed presenters, and 280 (28.9%) were late testers. In multinomial logistic regression analysis, injection drug use significantly increased (odds ratio [OR]= 5.04) the probability of delayed presentation but reduced (OR = 0.55) the chance of late testing. A previous HIV-negative test was associated with a reduced risk of both delayed presentation (OR = 0.39) and late testing (OR = 0.36). Unemployment was positively associated with delayed presentation and increasing age with late testing, whereas HIV counseling at the time of first positive HIV test strongly (OR = 0.42) reduced the odds of delayed presentation. Interventions aimed at promoting timely access to care of HIV-infected persons should consider differentiated programs for delayed presentation and late testing.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Cohort Studies
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Population Surveillance*
  • Regression Analysis
  • Risk Factors
  • Sexual Behavior
  • Substance Abuse, Intravenous
  • Surveys and Questionnaires
  • Unemployment