Risk Factors of Delayed HIV Diagnosis in Taiwanese Men Who Have Sex with Men
2008 Vol.24 NO.11
Correspondence Author： Shan-Chwen Chang
Early diagnosis of human immunodeficiency virus (HIV) infection has great clinical and public health impact. Early HIV diagnosis and timely administration of antiretroviral therapy can result in not only the reduction of morbidities and mortalities in HIV-infected patients, but also decrease of patients’ viral load and risk of HIV transmission in public health aspects. However, a large proportion of HIV-infected patients still receive their first HIV diagnosis at advanced stage. In Taiwan, there has been an increase in the annual number of new HIV cases among men who have sex with men (MSM). In this study, structured interviews were conducted on 164 newly diagnosed HIV-infected MSM who received medical care at the National Taiwan University Hospital, to collect data on socio-demographic factors, clinical status, relationships with family and partners, self awareness of risk, and utilization of screening services before HIV diagnosis. Risk factors of late HIV diagnosis (CD4<200/μL) were analyzed. The study showed that 46% of newly diagnosed HIV-infected patients had late HIV diagnosis. In multivariate analysis, three factors were significantly associated with late HIV diagnosis: age more than 24 years [Odds ratio (OR)=3.26; 95% confidence interval (CI): 1.08-9.83], diagnosis because of symptoms (rather than diagnosis through screening) [OR 5.70; 95% CI 2.53-12.8], last unprotected sex more than 6 months before HIV diagnosis [OR 6.19; 95% CI 2.70-14.2]. Late HIV diagnosis is prevalent among HIV-infected MSM in Taiwan. Health policy should focus on enhancing self-awareness of risk and utilization of screening services among MSM to facilitate early HIV diagnosis in this risk population.
Keyword: HIV infection, men who have sex with men, late diagnosis, HIV screening