Study: Many Discover HIV Late

By ERIN McCLAM, Associated Press from the NEW YORK TIMES

ATLANTA -- More than 40 percent of HIV-positive Americans don't know they are infected until just before developing full-blown AIDS, sometimes missing out on a decade or more of treatment, suggests a government study released Tuesday.

The study of about 19,000 AIDS patients found about two in five first tested positive for HIV within a year of being diagnosed with AIDS. The disease usually develops 10 to 11 years after HIV infection.

While health officials can't be certain the data from 12 states make a nationwide trend, they say the sample shows an urgent need for more people to get HIV tests and for more doctors to recommend them as at-risk patients.

"Significant numbers of people with HIV are only finding out about their infection when they feel sick," said Dr. Ronald Valdiserri, deputy director of HIV prevention for the U.S. Centers for Disease Control and Prevention. "We must reach these individuals at an earlier stage of infection for their own health and to prevent transmission to others."

The study, based on interviews of patients diagnosed with AIDS between 1990 and 1999, was presented at an HIV prevention conference in Atlanta.

About four times as many men as women were surveyed. But the proportion who tested late for HIV was nearly identical across gender and race.

A similar survey completed in 1992 -- when health officials knew much less about HIV/AIDS and how to treat it -- found that about half of HIV-positive people had learned their HIV status within a year of being diagnosed with AIDS.

In a separate study released Tuesday, researchers at Kaiser Permanente found that 40 percent of HIV-infected patients had HIV risk factors or possible symptoms on their charts for more than a year before they were tested.

The risk factors and symptoms, including other sexually transmitted diseases, should have prompted earlier testing, the study's authors said.

And a third study of homosexual men infected with syphilis in Chicago found that about one-third had never been tested for HIV, which is increasingly linked to syphilis. Many of the men said they had not been tested because they did not want to know the results.

The studies, coupled with new data that show the decline in new reported AIDS cases is flattening out, paint a frightening picture. Health officials worry the country may be headed for a new wave of HIV/AIDS infections.

"These data tell us that when it comes to HIV nothing is simple," said Leo Hurley, one of the Kaiser Permanente researchers. "We don't talk about HIV with our friends, our partners or our health care providers. We don't like admitting to ourselves we might be at risk."

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