Late HIV diagnosis often follows several earlier contacts with health services for conditions that should have prompted a test. Indicator conditions include tuberculosis, any sexually transmitted infection, hepatitis B or C, lymphoma, unexplained lymphadenopathy, herpes zoster in a younger adult, community-acquired pneumonia, unexplained weight loss or fever, and unexplained leucopenia or thrombocytopenia.
Making the test routine for these conditions, rather than dependent on a risk history, is what finds people earlier.
- Offer HIV testing to every patient diagnosed with tuberculosis or a sexually transmitted infection.
- Test patients with hepatitis B or C, lymphoma or unexplained cytopenias.
- Consider testing in herpes zoster in younger adults and in community-acquired pneumonia.
- Offer the test as routine; do not wait for the patient to disclose a risk.
Why it matters
Most late diagnoses had earlier clinical encounters where a test was not offered.
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