Late diagnosis of HIV infection is associated with unfavourable clinical outcomes especially among the elderly because the disease progresses faster and their survival is shorter compared to their younger counterparts. Information on the timeliness of HIV diagnosis and associated factors among the elderly is scanty.
To estimate the proportion of elderly persons with a late first HIV diagnosis attending Kampala Capital City Authority (KCCA) HIV clinics and to explore the associated factors.
This was a sequential explanatory mixed methods study involving 202 HIV infected persons aged 50 years and above at the time of their first diagnosis at six KCCA HIV clinics in Kampala. Their CD4 count at the time of diagnosis was assessed, and their individual and socioeconomic information was obtained from medical records. The perceptions of the participants, and those of health workers and policy makers towards timeliness of HIV diagnosis among the elderly was sought through in-depth and key informant interviews respectively. Factors associated with late diagnosis were analysed quantitatively using the chi-square test at bivariable level and Modified Poisson regression at the multivariable level to take into account potential confounding, and qualitative data was sorted, coded and presented using quotes.
64.9% of the elderly patients attending KCCA HIV clinics between 2017 and 2108 were diagnosed late. The prevalence of late diagnosis among overweight and obese participants was 0.7 (95%CI: 0.5-0.9) times the prevalence among participants with normal BMI. Respondents indicated that the elderly had a low self-perceived risk of having HIV which together with their belief in misconceptions regarding HIV cause their delays in diagnosis. Also, a low index of suspicion among the health workers and limited focus on the elderly were mentioned as contributors to delayed diagnosis of HIV among the elderly.
Conclusion This study provides evidence of a large number of the elderly diagnosed late for HIV, and highlights the need for targeted HIV screening interventions for the elderly who are a vulnerable group that is prone to the detrimental effects of late diagnosis.||en_US