Abstract
Different definitions of late HIV diagnosis are used to represent people diagnosed at an advanced stage of their illness. How well varying definitions represent those at risk for poor outcomes is unclear. Our aim was to examine proportions of late, delayed and timely HIV diagnoses in Florida and identify factors associated with diagnosis status. Using the first laboratory test in the Enhanced HIV/AIDS Reporting System, we determined annual proportions of late (CD4 < 200 cells/μL), delayed (200 ≤ CD4 < 350 cells/μL) and timely (CD4 ≥ 350 cells/μL) diagnoses in Florida between 2015 and 2021 and assessed characteristics associated with diagnosis status using multinomial logistic regression models. Among 30,411 individuals (20% female, 39% non-Hispanic Black, 34% Hispanic, mean age 37.1 years), 22% had a late and 17% had a delayed diagnosis. Non-Hispanic Black race, older age, and diagnosis at an inpatient facility were associated with greater odds of having a late or delayed diagnosis compared with having a timely diagnosis. There was no change in the prevalence of late, delayed, and timely diagnoses each year during the study period. Nearly 40% of HIV diagnoses in Florida were late or delayed. Given those with late and delayed diagnoses were similar, strategies to improve timeliness of diagnosis among these groups are needed.