Some HIV-positive people taking longer to initiate treatment

Oct 30 2007

Some HIV-positive people in key demographic groups do not seek treatment any sooner than they did in the past, and some people now take longer to initiate treatment, according to a study published in the Nov. 15 issue of Clinical Infectious Diseases, United Press International reports (United Press International, 10/27).

For the study, Jeanne Keruly and Richard Moore of Johns Hopkins University School of Medicine analyzed data of 3,300 HIV-positive people seeking treatment from the Johns Hopkins AIDS Service from 1990 to 2006. The data were examined as a whole and as demographic subsets that included gender, race, injection drug users, heterosexuals and men who have sex with men. The researchers examined the amount of time between HIV diagnosis and the time when a person sought treatment. They also looked at the HIV-positive person's immune status at the onset of care.

The study found that among all men, the average length between diagnosis and seeking care was 270 days at the beginning of the study, decreasing to 183 days by the end. White men and MSM tended to seek care sooner after being diagnosed with HIV, the study found. Women's times to seek treatment after diagnosis remained fairly constant throughout the study. Among IDUs, times to seek treatment after diagnosis increased from an average of 378 days at the beginning of the study to 630 days at the conclusion, according to the study.

People in all demographic categories, with the exception of MSM, demonstrated a trend of increased disease progression -- likely indicating that people are receiving HIV tests later after they contracted the virus than in the past -- the study found. The level of progression put the participants at an increased risk of poorer clinical outcomes from antiretroviral therapy than if they had presented earlier for care. In response to the findings, the researchers called on Maryland to implement new strategies to provide earlier HIV testing and referral to HIV care and treatment (Infectious Diseases Society of America release, 10/25).

The study is available online.