Circumstances at HIV Diagnosis and Progression of Disease in Older HIV-infected Americans

Overview

Journal Am J Public Health

Specialty Public Health

Date 2001 Jul 10

PMID 11441741

Citations 12

Authors

D S Zingmond

N S Wenger

S Crystal

G F Joyce

H Liu

U Sambamoorthi

L A Lillard

A A Leibowitz

M F Shapiro

S A Bozzette

Affiliations

Soon will be listed here.

Abstract

Objectives: This study identified age-related differences in diagnosis and progression of HIV by analyzing a nationally representative sample of HIV-infected adults under care in the United States.

Methods: We compared older (> or = 50 years) and younger participants stratified by race/ethnicity. Regression models controlled for demographic, therapeutic, and clinical factors.

Results: Older non-Whites more often had HIV diagnosed when they were ill. Older and younger patients were clinically similar. At baseline, however, older non-Whites had fewer symptoms and were less likely to have AIDS, whereas at follow-up they had a trend toward lower survival.

Conclusions: Later HIV diagnosis in non-Whites merits public health attention; clinical progression in this group requires further study.

Citing Articles

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Indicators of self-reported human immunodeficiency virus risk and differences in willingness to get tested by age and ethnicity: An observational study.

Brown B, Marg L, LeComte-Hinely J, Brinkman D, Zhang Z, Sullivan G Medicine (Baltimore). 2018; 97(31):e11690.

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Barriers and facilitators to HIV testing in people age 50 and above: a systematic review.

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Trends in HIV Testing Among U.S. Older Adults Prior to and Since Release of CDC's Routine HIV Testing Recommendations: National Findings from the BRFSS.

Ford C, Mulatu M, Godette D, Gaines T Public Health Rep. 2015; 130(5):514-25.

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Recent HIV Testing Prevalence, Determinants, and Disparities Among U.S. Older Adult Respondents to the Behavioral Risk Factor Surveillance System.

Ford C, Godette D, Mulatu M, Gaines T Sex Transm Dis. 2015; 42(8):405-10.

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References

Wutoh A, Hidalgo J, Rhee W, BARETA J . A characterization of older AIDS patients in Maryland. J Natl Med Assoc. 1998; 90(6):369-73. PMC: 2568238. View

Skiest D, Keiser P . Human immunodeficiency virus infection in patients older than 50 years. A survey of primary care physicians' beliefs, practices, and knowledge. Arch Fam Med. 1997; 6(3):289-94. DOI: 10.1001/archfami.6.3.289. View

Shapiro M, Berk M, Berry S, Emmons C, Athey L, Hsia D . National probability samples in studies of low-prevalence diseases. Part I: Perspectives and lessons from the HIV cost and services utilization study. Health Serv Res. 1999; 34(5 Pt 1):951-68. PMC: 1089067. View

Frankel M, Shapiro M, Duan N, Morton S, Berry S, Brown J . National probability samples in studies of low-prevalence diseases. Part II: Designing and implementing the HIV cost and services utilization study sample. Health Serv Res. 1999; 34(5 Pt 1):969-92. PMC: 1089068. View

Vanhems P, Baratin D, Allard R, Marceillac E, Biron F, Cotte L . Factors associated with the time elapsed between the initial detection of HIV-1 antibodies and a diagnosis of AIDS among patients followed in Lyons University Hospitals. CISIH Collaborators. Sex Transm Infect. 2001; 75(6):389-91. PMC: 1758255. DOI: 10.1136/sti.75.6.389. View

Ward J, Bush T, Perkins H, Lieb L, Allen J, Goldfinger D . The natural history of transfusion-associated infection with human immunodeficiency virus. Factors influencing the rate of progression to disease. N Engl J Med. 1989; 321(14):947-52. DOI: 10.1056/NEJM198910053211406. View

Porter K, Wall P, Evans B . Factors associated with lack of awareness of HIV infection before diagnosis of AIDS. BMJ. 1993; 307(6895):20-3. PMC: 1678470. DOI: 10.1136/bmj.307.6895.20. View

Stall R, Catania J . AIDS risk behaviors among late middle-aged and elderly Americans. The National AIDS Behavioral Surveys. Arch Intern Med. 1994; 154(1):57-63. View

Rosenberg P, Biggar R, Goedert J . Declining age at HIV infection in the United States. N Engl J Med. 1994; 330(11):789-90. DOI: 10.1056/NEJM199403173301114. View

10.

Ward J . Transfusion-associated (T-A)-AIDS in the United States. Dev Biol Stand. 1993; 81:41-3. View

11.

Gordon S, Thompson S . The changing epidemiology of human immunodeficiency virus infection in older persons. J Am Geriatr Soc. 1995; 43(1):7-9. DOI: 10.1111/j.1532-5415.1995.tb06234.x. View

12.

El-Sadr W, Gettler J . Unrecognized human immunodeficiency virus infection in the elderly. Arch Intern Med. 1995; 155(2):184-6. View

13.

Chaisson R, Keruly J, Moore R . Race, sex, drug use, and progression of human immunodeficiency virus disease. N Engl J Med. 1995; 333(12):751-6. DOI: 10.1056/NEJM199509213331202. View

14.

Darby S, Ewart D, Giangrande P, Spooner R, Rizza C . Importance of age at infection with HIV-1 for survival and development of AIDS in UK haemophilia population. UK Haemophilia Centre Directors' Organisation. Lancet. 1996; 347(9015):1573-9. DOI: 10.1016/s0140-6736(96)91073-9. View

15.

Pezzotti P, Phillips A, Dorrucci M, Lepri A, Galai N, Vlahov D . Category of exposure to HIV and age in the progression to AIDS: longitudinal study of 1199 people with known dates of seroconversion. HIV Italian Seroconversion Study Group. BMJ. 1996; 313(7057):583-6. PMC: 2352019. DOI: 10.1136/bmj.313.7057.583. View

16.

Skiest D, Rubinstien E, Carley N, Gioiella L, Lyons R . The importance of comorbidity in HIV-infected patients over 55: a retrospective case-control study. Am J Med. 1996; 101(6):605-11. DOI: 10.1016/S0002-9343(96)00329-4. View

17.

Bozzette S, Berry S, Duan N, Frankel M, Leibowitz A, Lefkowitz D . The care of HIV-infected adults in the United States. HIV Cost and Services Utilization Study Consortium. N Engl J Med. 1998; 339(26):1897-904. DOI: 10.1056/NEJM199812243392606. View