Factors Associated with Concurrent HIV and AIDS Diagnoses in Philadelphia, 2005-2007

Background: Early HIV diagnosis leads to decreased transmission, longer survival and slowed disease progression. This study was aimed at determining factors associated with a concurrent diagnosis of HIV and AIDS in Philadelphia. Methods: Data from the Philadelphia HIV/AIDS reporting system (13 years and older) diagnosed between 2005 and 2007 were analyzed (N=4,014). Concurrent diagnosis was defined as an AIDS diagnosis within 12 months of the initial HIV diagnosis. Data were analyzed using univariate chi square analysis and multivariate logistic regression to identify characteristics associated with a concurrent diagnosis. Results: Males (0R=1.1, p=0.01), age 30 years and older (0R=2.6, p<0.0001), and black race (OR 1.2, p=0.005) were all demographic factors associated with concurrent infection. Individuals were significantly more likely to have a concurrent diagnosis if diagnosed in an inpatient setting (OR = 1.03, p < 0.0001). Diagnoses made at counseling and testing or prison settings were less likely to be concurrent (OR=0.5, p<0.001). There was a significant decrease in the proportion of newly diagnosed individuals with a concurrent diagnosis between 2005 and 2007, dropping from 40.0% in 2005 to 36.4% in 2007 (p = 0.02). Conclusions: The large proportion of new HIV diagnoses with a concurrent AIDS diagnosis continues to be a public health concern. The disproportionate numbers of males, older persons, black/African indicates a need for greater focus of early intervention strategies in these populations. The decrease in concurrent HIV and AIDS diagnoses over the last three years may be early evidence of success of expanded testing programs in Philadelphia.