Late HIV Testing --- 34 States, 1996--2005
"Without effective antiretroviral therapy, most persons infected with human immunodeficiency virus (HIV) will progress to acquired immunodeficiency syndrome (AIDS) in approximately 10 years (1). Testing, diagnosis, and medical care soon after HIV infection and before developing AIDS can prevent unnecessary morbidity and mortality and reduce further HIV transmission. Persons who receive an AIDS diagnosis concurrently or soon after receiving their initial HIV diagnosis (e.g., ≤3 years) represent missed opportunities for prevention and treatment (2). A Healthy People 2010 developmental objective is to increase the proportion of new HIV infections diagnosed before progression to AIDS.* To characterize late HIV testing, CDC examined data from 1996--2005 from 34 states† with confidential name-based HIV and AIDS reporting (the most recent data available) to determine the percentage of persons who received an AIDS diagnosis ≤3 years after receiving their initial HIV diagnosis. The results indicated that, within 1 year of their HIV diagnosis, 38.3% of patients had received an AIDS diagnosis; another 6.7% received an AIDS diagnosis from 1 to 3 years after their HIV diagnosis. Compared with whites, greater percentages of persons of all other racial/ethnic populations received an AIDS diagnosis ≤3 years after their initial HIV diagnosis. These findings underscore the need for comprehensive HIV testing programs that include both routine screening of persons aged 13--64 years and more frequent testing for persons at increased risk and, therefore, in greater need of periodic HIV testing.

HIV infection and AIDS are notifiable health conditions in all 50 states, the District of Columbia, and five U.S. territories. Although all states have had AIDS reporting since the early 1980s, states have implemented HIV infection reporting over time; national HIV surveillance§ with uniform reporting was not implemented fully until 2008. CDC regards data from states with confidential, name-based, HIV surveillance systems sufficient to monitor trends and estimate risk behaviors for HIV infection after 4 years of reporting (3). The HIV and AIDS diagnosis data in this report were obtained from the 34 states with such reporting since December 2003..."