Presentation Abstract

Session: 099-Antiretroviral Therapy of HIV-1 Infection
Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Presentation Title: H2-792 - Late Presentation to HIV Care Among African-Americans and Hispanics/Latinos Since Adoption of Universal HIV Screening: A Persistent Problem
Location: Exhibit Hall F1
Poster Board Number: 279
Presentation Number: H2-792
Pres. Time: Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Category: H1
Keywords: HIV screening ; Late infection ; epidemiologic trends 
Author(s): S. M. Badri - Assistant Professor of Medicine, Division of Infectious Diseases1, J. Orsi - Statistician 2, R. J. Lubelchek - Assistant Professor of Medicine, Division of Infectious Diseases 1, A. L. French - Associate Professor of Medicine, Division of Infectious Diseases 1;
1John Stroger Hosp., Ruth M. Rothstein CORE Ctr., Rush Med. Coll., Chicago, IL, 2Chicago Ctr. for AIDS Res. (D-CFAR), Chicago, IL.
Financial Disclosures:  S. M. Badri, None..
J. Orsi, None. 
R. J. Lubelchek,
Gilead Role(s): Speaker's Bureau, Received: Speaker Honorarium.
A. L. French, None.
Abstract: Background: African-American (AA) and Hispanic/Latino (HL) patients (pts) disproportionately present late to HIV care. In 2006, CDC recommended routine HIV screening in pts aged 13-64 years to identify cases at earlier stages of disease. In this study, we describe the clinical characteristics of newly-diagnosed HIV+ pts at a large urban clinic over three years. Methods: Demographics, CD4 cell count, and HIV-1 RNA viral load (VL) of HIV-infected pts who presented for initial care to the Ruth M. Rothstein CORE Center, Chicago from 2006-2009 were studied. Late presenters are defined as having an initial CD4 count < 200 cells/mm3. Results: From 2006-2009, 1750 new pts were seen for an initial HIV visit; 775 (44%) had CD4 counts < 200, of which 508 (66%) pts had CD4 counts < 100. Two-thirds of late presentation occurred in minority groups, which reflect our patient population: 356 (46%) AA, 151 (20%) HL, 65 (8%) White, 178 (23%) unknown. Among late presenters, HLs were more likely than AAs to be younger and to have lower CD4 counts and higher VL. Conclusions: Delayed presentation to HIV care is ongoing despite revised CDC 2006 guidelines recommending routine, universal HIV testing. Strategies aimed at increasing acceptability and access to routine HIV testing should be targeted towards racial/ethnic minorities. Further study of the reasons for late presentation among HLs is warranted
Age years-median36.540< 0.01
CD4+ cells/µl-median5369NS
CD4+ cells/µl
< 50
69 (46%)
40 (26%)
42 (28%)
155 (44%)
64 (18%)
137 (38%)
< 0.05
HIV-1 RNA Viral Load (log 10 copies/ml)-median4.74.6< 0.05
Female (%)18%35%< 0.01

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