title: Late presentation of HIV disease and its associated factors among newly diagnosed patients before and after abolition of a government policy of mass mandatory screening.
abstract: OBJECTIVE
  To investigate the risk factors for late presentation in the Republic of Korea, where massive mandatory screening for HIV infection was conducted by the government until the late 1990s.
  
  
  METHODS
  Data over the period 1987-2008 were analyzed from HIV patients for whom records of CD4 cell counts within 3 months of HIV diagnosis were available. Using multivariate logistic regression analysis including demographic and clinical variables, we examined factors associated with late presentation, defined as having a CD4 cell count of less than 200 cells/mm(3) at the time of diagnosis.
  
  
  RESULTS
  Of a total of 994 patients with a new diagnosis of HIV infection, 405 (41%) were late presenters. As the proportion of patients diagnosed by mandatory screening decreased over time (31% in 1987-1998 versus 8% in 1999-2008, P < 0.001), the proportion of late presenters increased (31% in 1987-1998 versus 43% in 1999-2008, P = 0.007). The independent risk factors for late presentation were older age (adjusted odds ratio [aOR], per increase of 10 years, 1.31; 95% confidence interval [CI], 1.15-1.49; P < 0.001), male sex (aOR, 1.74; 95% CI, 1.03-2.95; P = 0.040), negativity for VDRL (aOR, 1.58; 95% CI, 1.16-2.14; P = 0.003), and diagnosis after 1999 (aOR, 1.64; 95% CI, 1.05-2.56; P = 0.031).
  
  
  CONCLUSIONS
  Older age, male sex, negativity for VDRL, and diagnosis after 1999, were associated with late presentation, and the proportion of late presenters increased after the mandatory testing policy was abolished.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Pyoeng Gyun
authors.initials: PG
authors.lastname: Choe
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Song
authors.forename: Nak-Hyun
authors.initials: NH
authors.lastname: Kim
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Park
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Myoung-Don
authors.initials: MD
authors.lastname: Oh
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis*; D006291:Health Policy; D006801:Humans; D016015:Logistic Models; D008297:Male; D018580:Mandatory Testing; D008875:Middle Aged; D056910:Republic of Korea; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult