Time of US HIV Infection to Diagnosis Decreases

In the United States, 38% of HIV transmissions occur from persons with undiagnosed HIV infection. The US Centers for Disease Control and Prevention (CDC) looked at the amount of time Americans went from being infected to diagnosed (Infx-to-Dx) with HIV from 2014-2017.

During this time, there were 157412 HIV diagnoses.

The median infection-to-diagnosis interval decreased from 43 months for persons with HIV diagnosed in 2014 to 40 months for persons with HIV diagnosed in 2017. This serves as a 2.3% annual decrease (P <0.001).

The drop in infection-to diagnosis interval was especially true in the American South and West.

Looking at these two geographic areas, in 41 jurisdictions with reliable estimates in 2017(relative standard errors < 30%), the median infection-to-diagnosis interval was <36 months for 10 (24.4%) jurisdictions, 36-47 months for 23 (56.1%), and '¥48 months for 8 (19.5%).

These two regions accounted for 71.2% of all HIV diagnoses from 2014-2017.

The findings, presented during the International AIDS Society (IAS) AIDS 2020 Virtual Sessions this week, provides data around the belief that access to testing has improved over time.

For its reporting methods, the CDC analyzed data reported to the National HIV Surveillance System (NHSS) from the 50 US States and the District of Columbia for HIV diagnoses occurring among persons aged >13 years in 2014-2017.

CDC calculated the interval between HIV infection and diagnosis by using HIV infection dates estimated based on a CD4 depletion model and HIV diagnosis dates reported to NHSS. Trends during this time period in the median number of months for Infx-to-Dx intervals were examined by using estimated annual percentage change.

While the numbers showed a positive decrease in the Infx-to-Dx interval, there is still a lot of lag time that needs to be addressed in the US.

“Delayed HIV diagnosis is substantial; one in two persons with HIV diagnosed in 2017 was infected at least 40 months before diagnosis,” the investigator wrote. “That the median Infx-to-Dx interval was longer than 36 months for three-quarters of jurisdictions underscores the importance of addressing local barriers to early diagnosis.”