Late Presentation and Missed Opportunities for HIV Diagnosis in Guatemala

Johanna Meléndez, Samuel W. Reinhardt, Jane A. O’Halloran, Andrej Spec, Andrea Alonzo Cordon, William G. Powderly, Carlos Mejia Villatoro

Research output: Contribution to journalArticle

Abstract

Early HIV diagnosis remains a challenge in many regions with delayed diagnosis resulting in increased morbidity and mortality. We conducted a retrospective cohort study of people living with HIV receiving outpatient care at a large tertiary referral center in Guatemala to describe the proportion of late presenters (LP) and missed opportunities for HIV diagnosis. Of 3686 patients, 2990 (81.1%) were LP who were more likely to be male (60.2% vs. 48.0%, p < 0.0001), heterosexual (88.0% vs. 78.0%, p < 0.0001) and rural dwellers (43.7% vs. 33.8%. p < 0.0001). The proportions of patients who presented late or with AIDS at diagnosis decreased over time. Only 665 patients (18.2%) sought care in the 2 years prior to HIV diagnosis. This study, the first of its kind in Central America to focus on late presenters and missed opportunities for HIV diagnosis, demonstrates extremely high rates of LP in Guatemala. Although in recent years rates of LP have improved somewhat, the need for screening outside of traditional healthcare settings is apparent.

Original languageEnglish
Pages (from-to)920-928
Number of pages9
JournalAIDS and Behavior
Volume23
Issue number4
DOIs
StatePublished - Apr 15 2019

Keywords

  • AIDS
  • Diagnosis
  • Guatemala
  • HIV

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