Correlates with Concurrent HIV/AIDS Diagnoses in the District of Columbia, 1997-2006

This study explored correlates of concurrent HIV/AIDS diagnoses (one month or less between diagnoses) in the District of Columbia.

Cases from the HIV/AIDS Reporting System (HARS) database that were reported to the District HIV/AIDS Administration from 1997-2006 were analyzed using logistic regression to determine correlates of concurrent diagnoses.

A total of 7,778 AIDS cases were reported from 1997-2006, of which 4,137 (53.2%) were concurrently diagnosed. Among men, blacks and Hispanics were significantly more likely than whites to be diagnosed concurrently (OR 1.44, 95% CI: 1.21-1.73; OR 1.47, 95% CI: 1.08-2.00; respectively). Among women, blacks were significantly less likely to be diagnosed concurrently than whites (OR=0.41, 95% CI 0.22-0.76). Those with no identified risk (59.1%) or infected through heterosexual contact (56.8%) were significantly more likely to have concurrent diagnoses compared to men who have sex with men (MSM) (OR 1.46, 95% CI: 1.24-1.73; OR 1.36, 95% CI: 1.18-1.57, respectively). Individuals lacking insurance were significantly more likely to have a concurrent diagnosis compared to individuals with public insurance (OR 1.94, 95% CI: 1.65-2.28). Patients with an opportunistic infection as the AIDS defining measure were more likely to have a concurrent diagnosis than patients with a low CD4 count (OR 1.48, 95% CI: 1.30, 1.69).

More than half of all AIDS cases in the District from 1997 to 2006 were diagnosed concurrently. Concurrent diagnoses represent missed opportunities for HIV prevention and treatment. Implementation of routine HIV screening in the District may reduce testing stigma and ensure earlier HIV diagnoses.