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Delayed presentation of HIV among older individuals: a growing problem

Justice AC 1 , Goetz MB 2 , Stewart CN 3 , Hogan BC 3 , Humes E 3 , Luz PM 4 Show all authors , Castilho JL 5 , Nash D 6 , Brazier E 7 , Musick B 8 , Yiannoutsos C 9 , Malateste K 10 , Jaquet A 10 , Cornell M 11 , Shamu T 12 , Rajasuriar R 13 , Jiamsakul A 14 , Althoff KN 3

Affiliations 

  • 1 VA Connecticut Healthcare System, Yale Schools of Medicine and Public Health, Yale University, West Haven, CT, USA. Electronic address: amy.justice2@va.gov
  • 2 VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
  • 3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
  • 4 Affiliation Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
  • 5 Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
  • 6 City University of New York Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
  • 7 Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
  • 8 Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, IN, USA
  • 9 Department of Biostatistics, Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
  • 10 Inserm, French National Research Institute for Sustainable Development, Universite de Bordeaux, Bordeaux, France
  • 11 Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  • 12 Graduate School of Health Sciences, Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland
  • 13 Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 14 Biostatistics and Databases Program, The Kirby Institute, UNSW, Sydney, NSW, Australia
Lancet HIV, 2022 Apr;9(4):e269-e280.
PMID: 35218732 DOI: 10.1016/S2352-3018(22)00003-0

Abstract

Late presentation for care is a major impediment to the prevention and effective treatment of HIV infection. Older individuals are at increased risk of late presentation, represent a growing proportion of people with late presentation, and might require interventions tailored to their age group. We provide a summary of the literature published globally between 2016-21 (reporting data from 1984-2018) and quantify the association of age with delayed presentation. Using the most common definitions of late presentation and older age from these earlier studies, we update this work with data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium, focusing on data from 2000-19, encompassing four continents. Finally, we consider how late presentation among older individuals might be more effectively addressed as electronic medical records become widely adopted.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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