CHARACTERISTICS OF PERSONS WITH LATE AIDS DIAGNOSIS IN THE UNITED-STATES

To describe characteristics of persons with late (at or after death) a cquired immunodeficiency syndrome (AIDS) diagnosis, we analyzed nation al surveillance data among all persons with AIDS diagnosed through Dec ember 1991 under the pre-1993 AIDS case definition and with a known da te of death. Late diagnosis was present in 15.8% of 163,202 deceased p ersons with AIDS and in 15.3% of deceased men with AIDS, 20.6% of wome n, 12.1% of whites, 20.0% of blacks, 21.1% of Hispanics, 12.3% of men who have sex with men (MSM), 21.9% of injecting drug users (IDU), and 19.6% of persons exposed to human immunodeficiency virus (HIV) through heterosexual contact. When age, race/ethnicity, sex, geographic regio n, and transmission mode were included in logistic regression analyses , among adults/adolescents, late diagnosis was more likely among perso ns 40 years or older than among those 13-39 years old, among blacks an d Hispanics than among whites, and among IDU and persons exposed to HI V through heterosexual contact than among MSM. Although children (less than 13 years of age) were more likely to have late diagnosis than ad ults and adolescents, late diagnoses among children did not differ sig nificantly by race/ethnicity, sex, geographic region, or transmission mode. Late AIDS diagnosis, especially among ethnic minorities and IDU and their sex partners, may represent delays in HIV diagnosis and care . In addition to not receiving early clinical intervention, persons wh o are diagnosed later in the course of HIV disease represent missed op portunities for receiving prevention efforts such as education, counse ling, and substance abuse treatment. Monitoring the characteristics of persons with late AIDS diagnosis can be used to identify populations in whom HIV disease may be underrecognized or persons who do not gain access to health care services until late in HIV disease.