{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:16:39Z","timestamp":1776269799712,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2021,1,30]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The goal of 90-90-90 first requires the expansion of access to HIV testing. Our aim was to record frequencies of HIV indicator conditions (ICs) and identify missed opportunities for an early HIV diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively identified ICs in a population of 231 people living with HIV with known infection dates who attended our clinic. The study population was divided into four groups: (1) those self-tested pre-emptively (47\/231, 20.3%), (2) those offered targeted testing based on risk factors (67\/231, 29%), (3) those tested after an IC (73\/231, 31.6%) and (4) those who were not offered testing after an IC (44\/231, 19%). HIV acquisition dates were estimated by molecular clock analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 169 healthcare contacts (HCCs) were recorded. The most frequent HCC was mononucleosis-like syndrome (20.1%), unexplained weight loss (10.7%) and STIs (10.1%). AIDS-defining conditions were detected in 11.8%. Only 62.4% (73\/117) of those with an IC were offered testing after their first HCC. Patients in group 4 had statistically significant delay in diagnosis compared with group 3 (109.1 weeks (IQR 56.4\u2013238.6) vs 71.6 weeks (IQR 32.3\u2013124.6)). The proportion of patients diagnosed as late presenters in each group was: (1) 16\/47 (34%), (2) 37\/67 (55.2%), (3) 43\/73 (58.9%) and (4) 27\/44 (61.4%) (p=0.027).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study uses a combination of molecular and clinical data and shows evidence that late presentation occurs in a high proportion of patients even in the presence of an IC. Given that risk-based targeted testing has low coverage, IC-guided testing provides a reasonable alternative to facilitate earlier HIV diagnosis and to improve late diagnosis across Europe and globally.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054697","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T23:00:48Z","timestamp":1613775648000},"page":"79-84","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Tracking missed opportunities for an early HIV diagnosis in a population of people living with HIV with known time of infection"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-872X","authenticated-orcid":false,"given":"Dimitrios","family":"Basoulis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-0930","authenticated-orcid":false,"given":"Evangelia Georgia","family":"Kostaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Paraskevis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelos","family":"Hatzakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Psichogiou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2024092104100597000_98.2.79.1","doi-asserted-by":"crossref","first-page":"S213","DOI":"10.1097\/QAD.0000000000002355","article-title":"Global, regional and country-level 90-90-90 estimates for 2018: assessing progress towards the 2020 target","volume":"33 Suppl 3","author":"Marsh","year":"2019","journal-title":"AIDS"},{"key":"2024092104100597000_98.2.79.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq243"},{"key":"2024092104100597000_98.2.79.3","unstructured":"WHO . Progress report on HIV, viral hepatitis and sexually transmitted infections, 2019. accountability for the global health sector strategies, 2016\u20132021. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/324797\/WHO-CDS-HIV-19.7-eng.pdf?ua=1"},{"key":"2024092104100597000_98.2.79.4","unstructured":"ECDC . HIV\/AIDS surveillance in Europe. 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Guidance document: HIV indicator conditions: guidance for implementing HIV testing in adults in health care settings. 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Estimating the infection time among people who inject drugs during an HIV-outbreak in Athens,Greece: Evidence that interventions significantly decreased the number of new transmissions. Stockholm, Sweden: European Scientific Conference on Applied Infectious Disease Epidemiology, 2019."},{"key":"2024092104100597000_98.2.79.21","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054509"},{"key":"2024092104100597000_98.2.79.22","unstructured":"Limnaios S , Kostaki EG , Adamis G . Inference of the HIV infection dates in Greece using a dense sampling of molecular sequences. presented at: 10th IAS conference on HIV science. 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