Factors associated with late HIV diagnosis in North-East Scotland: a six-year retrospective study

G. Noble, E. Okpo, I. Tonna, S. Fielding

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Late HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland.

Study design
A population based retrospective database analysis.

All newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests.

CD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants.

Heterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.
Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalPublic Health
Early online date5 Jul 2016
Publication statusPublished - Oct 2016

Bibliographical note

The authors would like to thank Drs. Steve Baguley, Ambreen Butt, and Daniela Brawley for their help with the review of case notes in the Genitourinary Medicine (GUM) Clinic.

Ethical approval
The study has been carried out in compliance with the Declaration of Helsinki.21 Ethical approval was granted by the North of Scotland Research Ethics Committee (REC reference 15/NS/0056).

None declared.


  • HIV
  • late diagnosis
  • missed diagnosis
  • CD4 cell count


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