Although primary human immunodeficiency virus infection (PHI) is usually symptomatic and early management is likely important, the diagnosis is infrequently made. We examined a prospectively enrolled cohort of individuals diagnosed as having PHI in the southeastern United States to determine problems associated with the diagnosis of PHI. The following information was collected on each individual: site of initial presentation, number of visits to health care settings before diagnosis, diagnosing physician, alternative diagnoses, presumptive therapies, and time to diagnosis of PHI. Data were available for 29 of 30 patients (17 white, 12 nonwhite). Most patients were seen at least 3 times before the diagnosis of PHI was made. White persons were seen more frequently by primary care providers (P = .09). Nonwhite persons were diagnosed more quickly (P = .045). Only 5 patients (17%) were correctly diagnosed during their first encounter with the health care system, while 5 (17%) remained undiagnosed for more than 1 month after first presentation. Infectious diseases specialists diagnosed 83% of the cases. Human immunodeficiency virus is infrequently diagnosed during primary infection. More expeditious diagnosis of human immunodeficiency virus infection is a clinical and public health imperative.
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Site of initial presentation by ethnicity. PCP indicates primary care provider; UCS, urgent care setting (including urgent care clinics and emergency departments). Nonwhite includes African American, Hispanic, and Native American. P= .09.
Number of visits to a health care provider before diagnosis by ethnicity. Nonwhite includes African American, Hispanic, and Native American. P= .045.
Algorithm for diagnosing primary human immunodeficiency virus (HIV) infection. PCR indicates polymerase chain reaction; ELISA, enzyme-linked immunosorbent assay.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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