{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:01:18Z","timestamp":1781157678650,"version":"3.54.1"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005856","name":"Faculdade de Ci\u00eancias e Tecnologia, Universidade Nova de Lisboa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005856","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Epidemiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Late diagnosis of HIV infection remains a major public health challenge, associated with higher morbidity and mortality, ongoing transmission, opportunistic infections, and higher healthcare costs. Despite free access to HIV-1 testing and antiretroviral therapy in Cabo Verde, the prevalence and determinants of late HIV diagnosis remain poorly characterised. Therefore, this study aimed to assess the prevalence of late HIV diagnosis and identify associated factors among newly diagnosed, treatment-na\u00efve individuals with HIV-1 in Cabo Verde.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study combining interview - based data with retrospective extraction of clinical data was conducted among 135 newly diagnosed, treatment - na\u00efve individuals between 2018 and 2019 across four islands of Santiago, Fogo, S\u00e3o Vicente, and Boavista. Late HIV diagnosis was defined as CD4+\u2009&amp;lt;\u2009350\u2005cells\/\u00b5L at diagnosis or the presence of an AIDS-defining condition. Sociodemographic and clinical data were collected, and viral genetic diversity was assessed through nucleotide ambiguity analysis. Associations with late HIV diagnosis were evaluated using univariable and multivariable logistic regression, presented as odds ratios (OR) and 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 56.3% (76\/135) of individuals were classified as having late HIV diagnosis. In multivariable analysis, being single (aOR: 2.79; 95% CI: 1.13\u20136.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) and having viral load \u22655.0\u2005log copies\/mL (aOR: 5.24; 95% CI: 1.80\u201315.25;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) were independently associated with late HIV diagnosis. Genetic ambiguity analysis showed a predominance of recent infections (68.3%), with low concordance with CD4+ T-cell counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HIV-1 late diagnosis remains highly prevalent in Cabo Verde and is associated with single marital status and higher viral load. These findings highlight persistent gaps in early HIV testing and timely linkage to care. Strengthening targeted testing strategies is essential to improve clinical outcomes and reduce HIV transmission, in line with the UNAIDS 95-95-95 targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fepid.2026.1861884","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:21Z","timestamp":1781156841000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV-1 late diagnosis in Cabo Verde: associated factors and implications for preventive strategies"],"prefix":"10.3389","volume":"6","author":[{"given":"Silv\u00e2nia da Veiga","family":"Leal","sequence":"first","affiliation":[{"name":"Instituto Nacional de Sa\u00fade P\u00fablica de Cabo Verde, Largo do Desastre da Assist\u00eancia, Ch\u00e3 de Areia","place":["Praia, Cabo Verde"]},{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mafalda N. S.","family":"Miranda","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Parreira","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel In\u00eas Monteiro de Pina","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]},{"name":"Faculdade de Ci\u00eancias e Tecnologia, Universidade de Cabo Verde, Campus do Palmarejo Grande","place":["Praia, Cabo Verde"]},{"name":"One Health Research Center-Cabo Verde (NEST-CV), Universidade de Cabo Verde, Campus do Palmarejo Grande","place":["Praia, Cabo Verde"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pingarilho","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B.","family":"Abecasis","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"B1","volume-title":"Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV","year":"2015"},{"key":"B2","volume-title":"Guidelines for Managing Advanced HIV Disease and Rapid Initiation of Antiretroviral Therapy","year":"2017"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S197","DOI":"10.1097\/QAD.0000000000002983","article-title":"The joint united nations programme on HIV\/AIDS 95-95-95 targets: worldwide clinical and cost benefits of generic manufacture","volume":"35","author":"Heath","year":"2021","journal-title":"AIDS"},{"key":"B4","volume-title":"Fast-Track: Ending the AIDS Epidemic by 2030","year":"2014"},{"key":"B5","volume-title":"Global HIV Statistics","year":"2024"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1093\/ije\/dyr080","article-title":"Cohort profile: the international epidemiological databases to evaluate AIDS (IeDEA) in sub-Saharan Africa","volume":"41","author":"Egger","year":"2012","journal-title":"Int J Epidemiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1097\/QAI.0b013e3182821821","article-title":"Mortality, AIDS-morbidity, and loss to follow-up by current CD4 cell count among HIV-1\u2013infected adults receiving antiretroviral therapy in Africa and Asia","volume":"62","author":"Gabillard","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1097\/QAI.0b013e3181ab6eab","article-title":"Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in sub-Saharan Africa","volume":"52","author":"Kigozi","year":"2009","journal-title":"J Acquir Immune Defic Syndr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e1001510","DOI":"10.1371\/journal.pmed.1001510","article-title":"Risk factors and outcomes for late presentation for HIV-positive persons in Europe: results from the collaboration of observational HIV epidemiological research Europe study (COHERE). 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