{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:37Z","timestamp":1777927417018,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T00:00:00Z","timestamp":1663459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Background<\/jats:title>\n \n New late HIV diagnosis (CD4 count <350cells\/mm\n 3<\/jats:sup>\n ) are higher in North West England compared to the UK average. A Greater Manchester-wide audit into individuals diagnosed with late or very late HIV was conducted in 2016 and re-audited in 2019. Our aim was to gain intelligence into key demographics of late diagnosed individuals across Greater Manchester, review opportunities for earlier diagnosis and determine if key recommendations from the 2016 audit were followed.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Individuals were identified from locally kept data or HIV and AIDS Reporting System (HARS) data. A retrospective case note review was performed for each patient using data from local notes, General Practice summary of care records and relevant clinical letters. Data was collected for 2019 and compared to 2016 results.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In 2016, nine departments contributed data and 104 individuals were identified as having been diagnosed late. In 2019, seven departments contributed data and 65 individuals were identified as having been diagnosed late. In both years, a greater proportion of males diagnosed late were White British and for females Black African. A greater proportion of late diagnosis occurred in men who have sex with men (MSM) and in heterosexual females. In 2019, a greater proportion of patients had an AIDS-defining illness at time of diagnosis. Whilst in 2016, most patients were asymptomatic. Over one third of patients had a clinical indicator disease in their past medical history, which is an increase in proportion from 2016. The proportion of cases where clinicians felt that there had been probable missed opportunities for earlier diagnosis also increased in 2019.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n There are continued missed opportunities for earlier diagnosis. We recommend targeted interventions for groups at higher risk of late presentation, education in primary\/secondary care regarding clinical indicator conditions, a formal review process for all late diagnosed cases, communication with primary\/secondary care if missed opportunities are identified and broader HIV testing especially in high prevalence areas.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/09564624221121201","type":"journal-article","created":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T21:21:07Z","timestamp":1663536067000},"page":"1078-1083","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A re-audit of individuals with a late diagnosis of HIV in 2016 and 2019 in Greater Manchester"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-2093","authenticated-orcid":false,"given":"Emily","family":"Boardman","sequence":"first","affiliation":[{"name":"Manchester Royal Infirmary, The Northern Contraception, Sexual Health and HIV Service Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Tomkins","sequence":"additional","affiliation":[{"name":"North Manchester, The Northern Contraception, Sexual Health and HIV Service Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chitra","family":"Babu","sequence":"additional","affiliation":[{"name":"Manchester Royal Infirmary, The Hathersage Centre, The Northern Contraception, Sexual Health and HIV Service, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,18]]},"reference":[{"key":"bibr1-09564624221121201","volume-title":"The annual official statistics data release (data to end of December 2020)","author":"Public Health England","year":"2021"},{"key":"bibr2-09564624221121201","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2010.00857.x"},{"key":"bibr3-09564624221121201","volume-title":"BHIVA guidelines for the treatment of HIV-1-positive adults with ART 2015 (2016 interim update)","author":"British HIV Association","year":"2016"},{"key":"bibr4-09564624221121201","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6016"},{"key":"bibr5-09564624221121201","volume-title":"Report","author":"Hartney T","year":"2012"},{"key":"bibr6-09564624221121201","volume-title":"Annual Epidemiological Spotlight on HIV in the North West 2019 data","author":"Public Health England","year":"2021"},{"key":"bibr7-09564624221121201","volume-title":"British HIV Association\/British Association for Sexual Health and HIV\/British Infection Association Adult HIV Testing Guidelines","author":"British HIV Association","year":"2020"},{"key":"bibr8-09564624221121201","volume-title":"HIV Indicator Conditions: Guidance for Implementing HIV Testing in Adults in Health Care Settings","author":"EuroTEST","year":"2014"},{"key":"bibr9-09564624221121201","volume-title":"HIV testing: encouraging uptake","author":"National Institute for Health and Care Excellence","year":"2017"},{"key":"bibr10-09564624221121201","volume-title":"British HIV Association Standards of Care for People Living with HIV","author":"British HIV Association","year":"2018"},{"key":"bibr11-09564624221121201","volume-title":"BHIVA Audit and Standards Subcommittee & NHS England HIV Clinical Reference Group: A proposed national process for investigating late diagnoses and potential missed opportunities for HIV testing","author":"British HIV Association","year":"2021"},{"key":"bibr12-09564624221121201","volume-title":"Towards Zero - An action plan towards ending HIV transmission, AIDS and HIV-related deaths in England - 2022 to 2025","author":"UK GOV","year":"2021"}],"container-title":["International Journal of STD & AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221121201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624221121201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221121201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:43:46Z","timestamp":1777675426000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624221121201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,18]]},"references-count":12,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1177\/09564624221121201"],"URL":"https:\/\/doi.org\/10.1177\/09564624221121201","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,18]]}}}