ArticlePloS one2019
Missed opportunities for earlier diagnosis of HIV in British Columbia, Canada: A retrospective cohort study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 42 citations in OpenAlex.
- Incidence of Herpes Zoster Infection (Shingles) Among Adults Living With and Without HIV in British Columbia, Canada: A Population-based Study.The Journal of infectious diseases · 2026Article
- Missed opportunities for HIV diagnosis in Mexico City: unveiling the sex gap.Frontiers in reproductive health · 2026Article
- Missed Opportunities for HIV Diagnosis and Their Clinical Repercussions in the Portuguese Population-A Cohort Study.Pathogens (Basel, Switzerland) · 2024Article
- Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities.Healthcare (Basel, Switzerland) · 2024Article
- Refractory HIV-Associated Guillain-Barré Syndrome Responsive to Antiretroviral Therapy: A Case Report.Case reports in infectious diseases · 2024Article
- Article
- Health Care Provider Discussions Regarding HIV/Sexually Transmitted Infection Risk Factors and Associations with HIV/Sexually Transmitted Infection Screening Among Men.Archives of sexual behavior · 2023Article
- [Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the "Urgències VIHgila" program].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Article
- Increasing HIV early diagnosis by implementing an automated screening strategy in emergency departments.HIV medicine · 2022Observational
- HIV testing in a high prevalence urban area in the US: Identifying missed opportunities two ways.International journal of STD & AIDS · 2022Article
- The impact of regional socioeconomic deprivation on the timing of HIV diagnosis: a cross-sectional study in Germany.BMC infectious diseases · 2022Article
- Missed opportunities for earlier diagnosis of HIV infection in people living with HIV in Thailand.PLOS global public health · 2022Article
- Disparities in multimorbidity and mortality among people living with and without HIV across British Columbia's health regions: a population-based cohort study.Canadian journal of public health = Revue canadienne de sante publique · 2021Article
- Article
- Benefits of opportunistic screening for sexually transmitted infections in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Evaluating a pilot process for reviewing late HIV diagnoses in England and Wales.Clinical medicine (London, England) · 2020Article
- When HIV Immunodeficiency and Heterochromia Confuse the Issue: Recurrent Zoster Uveitis Mistaken for Fuchs' Uveitis.Journal of ophthalmic & vision researchArticle
- Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundLate HIV diagnosis is associated with increased AIDS-related morbidity and mortality as well as an increased risk of HIV transmission. In this study, we quantified and characterized missed opportunities for earlier HIV diagnosis in British Columbia (BC), Canada.
designRetrospective cohort.
methodsA missed opportunity was defined as a healthcare encounter due to a clinical manifestation which may be caused by HIV infection, or is frequently present among those with HIV infection, but no HIV diagnosis followed within 30 days. We developed an algorithm to identify missed opportunities within one, three, and five years prior to diagnosis. The algorithm was applied to the BC STOP HIV/AIDS population-based cohort. Eligible individuals were ≥18 years old, and diagnosed from 2001-2014. Multivariable logistic regression identified factors associated with missed opportunities.
resultsOf 2119 individuals, 7%, 12% and 14% had ≥1 missed opportunity during one, three and five years prior to HIV diagnosis, respectively. In all analyses, individuals aged ≥40 years, heterosexuals or people who ever injected drugs, and those residing in Northern health authority had increased odds of experiencing ≥1 missed opportunity. In the three and five-year analysis, individuals with a CD4 count <350 cells/mm3 were at higher odds of experiencing ≥1 missed opportunity. Prominent missed opportunities were related to recurrent pneumonia, herpes zoster/shingles among younger individuals, and anemia related to nutritional deficiencies or unspecified cause.
conclusionsBased on our newly-developed algorithm, this study demonstrated that HIV-diagnosed individuals in BC have experienced several missed opportunities for earlier diagnosis. Specific clinical indicator conditions and population sub-groups at increased risk of experiencing these missed opportunities were identified. Further work is required in order to validate the utility of this proposed algorithm by establishing the sensitivity, specificity, positive and negative predictive values corresponding to the incidence of the clinical indicator conditions among both HIV-diagnosed and HIV-negative populations.
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