title: Late Diagnosis of HIV Infection in Metropolitan Areas of the United States and Puerto Rico.
abstract: The majority of persons infected with HIV live in large metropolitan areas and many such areas have implemented intensified HIV testing programs. A national indicator of HIV testing outcomes is late diagnosis of HIV infection (stage 3, AIDS). Based on National HIV Surveillance System data, 23.3 % of persons with HIV diagnosed in 2012 had a late diagnosis in large MSAs, 26.3 % in smaller MSAs, and 29.6 % in non-metropolitan areas. In the 105 large MSAs, the percentage diagnosed late ranged from 13.2 to 47.4 %. During 2003-2012, the percentage diagnosed late decreased in large MSAs (32.2-23.3 %), with significant decreases in 41 of 105 MSAs overall and among men who have sex with men. Sustained testing efforts may help to continue the decreasing trend in late-stage HIV diagnosis and provide opportunities for early care and treatment and potential reduction in HIV transmission.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, E-47, Atlanta, GA, 30329-4027, USA. ixh1@cdc.gov.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
authors.affiliation: ICF International, Atlanta, GA, USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Tang
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, E-47, Atlanta, GA, 30329-4027, USA.
authors.forename: Lorena
authors.initials: L
authors.lastname: Espinoza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D002947:Cities; D057210:Delayed Diagnosis; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D011159:Population Surveillance; D011647:Puerto Rico / Q000453:epidemiology; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: AIDS; CD4 count; Delayed diagnosis; Diagnosis; Disease stage; HIV; HIV testing