Factors Associated With Late HIV Diagnosis in Grampian: an Epidemiological Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Human Immunodeficiency Virus
- Sponsor
- University of Aberdeen
- Enrollment
- 124
- Locations
- 1
- Primary Endpoint
- Age at diagnosis
- Status
- Completed
- Last Updated
- 9 years ago
Overview
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Individuals diagnosed with HIV between January 2009 and December 2014
- •Individuals diagnosed in NHS Grampian
Exclusion Criteria
- •Individuals aged \< 16 years of age
Outcomes
Primary Outcomes
Age at diagnosis
Time Frame: 5 years
Age in years at diagnosis; compared between early and late diagnosis groups.
Gender
Time Frame: 5 years
Gender; compared between early and late diagnosis groups
Scottish Index of Multiple Deprivation (SIMD) Quintile
Time Frame: 5 years
SIMD quintile (1 representing most deprived to 5 representing least deprived); compared between early and late diagnosis groups
Ethnicity
Time Frame: 5 years
Ethnic group; compared between early and late diagnosis groups
Migrant status
Time Frame: 5 years
Migrant status in relation to the United Kingdom; compared between early and late diagnosis groups
Probable mode of transmission
Time Frame: 5 years
Probable mode of HIV transmission; compared between early and late diagnosis groups
Probable region of exposure
Time Frame: 5 years
Probable region of exposure to HIV; compared between early and late diagnosis groups
Registration with General Practitioner
Time Frame: 5 years
Current registration status with General Practitioner; compared between early and late diagnosis groups
Contact with healthcare professional
Time Frame: 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
Time Frame: 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
Time Frame: 5 years
Previous HIV testing (no testing versus testing); compared between early and late diagnosis groups
Clinical indicator disease
Time Frame: 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)
Time Frame: 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
Time Frame: 5 years
Presence or absence of a co-existing hepatitis B/C infection; compared between early and late diagnosis groups
Secondary Outcomes
- Frequency of missed opportunities for diagnosis(5 years)
- Circumstance of HIV diagnosis(5 years)