Delayed access to HIV diagnosis and care: Special concerns for the Southern United States

Abstract

HIV diagnosis and presentation to appropriate medical care during early stages of disease has substantial clinical and public health benefits. However, a large proportion of HIV-infected Americans experience diagnosis and treatment related delays. Prior research evaluating barriers to early HIV diagnosis and care presentation have been published primarily from large East and West coast urban centers. Therefore, predictors of delayed presentation to HIV care identified by these studies may not be generalizable to the South where infected persons are increasingly non-white, female, poor, non-urban, and possibly exposed to HIV heterosexually. We review here the benefits conferred by HIV care, descriptive epidemiology of delayed HIV diagnosis and care, and potential barriers to early medical care with special reference to conditions prevalent in the South.

Acknowledgments

This work was supported in part by National Institutes of Health grant number 5P30AI027767-17. The authors would also like to thank the following for their contributions to this work: from The University of Alabama at Birmingham School of Public Health, Dr. Richard Kaslow, Dr. Christopher Coffey, and Amita Bey; from the 1917 Outpatient Clinic in Birmingham, Alabama: Dr. Michael Saag, Dr. Jim Raper, Davendra Sohal, Ashlee Chatham, the health care providers and patients; and from Cooper Green Hospital St. Georges Clinic: Ann Atkinson.

Additional information

Notes on contributors

Christopher S. Krawczyk

Now affiliated with the California Department of Health Services, Office of AIDS

Sten H. Vermund

Now at Vanderbilt University School of Medicine