Factors Associated With Late HIV Diagnosis in Grampian: an Epidemiological Study
- Conditions
- Human Immunodeficiency Virus
- Interventions
- Other: No intervention
- Registration Number
- NCT02804724
- Lead Sponsor
- University of Aberdeen
- Brief Summary
Human immunodeficiency virus (HIV) is a major global health concern which has resulted in an estimated 39 million deaths world-wide. Although it is now a treatable medical condition there is still avoidable morbidity and mortality associated with HIV infection in the UK. Late diagnosis (CD4 count of \<350 cells/mm3 or AIDS-defining illness irrespective of CD4 count) is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased healthcare costs. In Grampian, 49% of patients were diagnosed late between 1984 and 2011. Therefore, the aim of the study is to determine the factors associated with late HIV diagnosis in Grampian between 2009 and 2014 to ascertain whether diagnoses could have been made earlier.
The study constitutes a secondary data analysis. Individuals newly diagnosed with HIV between January 2009 and December 2014 were identified from a Health Protection Scotland (HPS) database. The majority of outcome data were extracted from the existing HPS database. Missing data were collected via a retrospective review of patient case-notes, laboratory reports and an electronic patient management system. Patients were classified as early or late diagnosis and comparisons were made between the groups using statistical tests. The study sought to provide a basis for recommendations for improvement of information and services to facilitate earlier HIV diagnosis in Grampian.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 124
- Individuals diagnosed with HIV between January 2009 and December 2014
- Individuals diagnosed in NHS Grampian
- Individuals aged < 16 years of age
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Newly diagnosed individuals with HIV No intervention Individuals newly diagnosed with HIV in Grampian between January 2009 and December 2014
- Primary Outcome Measures
Name Time Method Age at diagnosis 5 years Age in years at diagnosis; compared between early and late diagnosis groups.
Gender 5 years Gender; compared between early and late diagnosis groups
Scottish Index of Multiple Deprivation (SIMD) Quintile 5 years SIMD quintile (1 representing most deprived to 5 representing least deprived); compared between early and late diagnosis groups
Ethnicity 5 years Ethnic group; compared between early and late diagnosis groups
Migrant status 5 years Migrant status in relation to the United Kingdom; compared between early and late diagnosis groups
Probable mode of transmission 5 years Probable mode of HIV transmission; compared between early and late diagnosis groups
Probable region of exposure 5 years Probable region of exposure to HIV; compared between early and late diagnosis groups
Registration with General Practitioner 5 years Current registration status with General Practitioner; compared between early and late diagnosis groups
Contact with healthcare professional 5 years Contact with healthcare professional(s) in the year preceding HIV diagnosis (contact versus no contact); compared between early and late diagnosis groups
Frequency of healthcare contacts 5 years Frequency of contact with healthcare professional(s) in the year preceding HIV diagnosis; compared between early and late diagnosis groups
Previous HIV testing 5 years Previous HIV testing (no testing versus testing); compared between early and late diagnosis groups
Clinical indicator disease 5 years Presence or absence of a BHIVA clinical indicator disease in the five years preceding diagnosis; compared between early and late diagnosis groups
Number of clinical indicator disease(s) 5 years Number of BHIVA clinical indicator disease(s) present in the five years preceding diagnosis; compared between early and late diagnosis groups
Co-existing hepatitis B/C infection 5 years Presence or absence of a co-existing hepatitis B/C infection; compared between early and late diagnosis groups
- Secondary Outcome Measures
Name Time Method Frequency of missed opportunities for diagnosis 5 years Number of missed opportunities for diagnosis as defined by the BHIVA testing guidelines; compared between early and late diagnosis groups
Circumstance of HIV diagnosis 5 years Circumstance of HIV diagnosis; no BHIVA clinical indicator disease present versus testing offered following detection of a BHIVA clinical indicator disease versus no testing offered following the detection of a BHIVA clinical indicator disease. Compared between early and late diagnosis groups
Trial Locations
- Locations (1)
NHS Grampian
🇬🇧Aberdeen, Aberdeen City, United Kingdom