Delayed Presentation for Human Immunodeficency Virus (HIV) Care Among Veterans

A Problem of Access or Screening?

The patterns of health care use by human immunodeficiency virus(HIV) patients at Veterans Health Administration (VA) centers was the focus of this research study. Participants were 4,368 HIV patients who had presented at a VA between 1998 and 2002. Outcomes of interest in the study were time to HIV presentation at a VA, the existence of any “clinical triggers,” or presence of other diagnostic conditions related to a higher risk of HIV infection, and AIDS rates within the year of HIV presentation.

Key Findings:

  • Slightly more than half of the participants presented at a VA when CD4 counts were low enough to indicate the presence of AIDS.
  • Of the study participants, 39 percent had received care at a VA for more than a year before they presented for care for HIV.
  • Participants reported a median of six visits to a physician and a median length of time of 3.6 years before presentation for HIV care.
  • Clinical triggers existed before HIV presentation for 13 percent of study participants.
  • In terms of CD4 count at baseline or the presence of AIDS-defining illness, patients new to the VA when they presented with HIV did not significantly differ from patients that had received care at the VA in the past.