LATE HIV DIAGNOSIS IN PRIMARY HEALTH CARE: ASSOCIATED FACTORS, MISSED OPPORTUNITIES AND CHALLENGES FOR EARLY DIAGNOSIS
DOI:
https://doi.org/10.63330/aurumpub.068-017Keywords:
Early Diagnosis, HIV, Primary Health Care, Testing, Unified Health SystemAbstract
Late diagnosis of HIV infection remains a relevant public health challenge despite the broad availability of rapid tests, antiretroviral therapy and combination prevention strategies within the Brazilian Unified Health System. This chapter aims to analyze factors associated with late HIV diagnosis, missed opportunities for detection in health services and the role of Primary Health Care in expanding early diagnosis. This is a narrative literature review based on official documents from the Brazilian Ministry of Health, the World Health Organization and UNAIDS, as well as national and international studies addressing HIV testing, late diagnosis, vulnerabilities and organization of care. Evidence indicates that delayed diagnosis results from the interaction of low risk perception, stigma, social and territorial inequalities, access barriers, insufficient testing offer and failures to recognize clinical indicator conditions. Part of the population diagnosed at advanced stages had previously contacted health services without HIV infection being investigated, which characterizes missed opportunities. Primary Health Care has strategic potential to change this pathway through longitudinal care, bonding, timely testing, combination prevention and care coordination. It is concluded that reducing late diagnosis requires normalization of HIV testing, professional qualification, reduction of stigma and effective integration among Primary Health Care, surveillance and specialized services.
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ANDRADE, L. A. et al. Reduced HIV/AIDS diagnosis rates and increased AIDS mortality due to late diagnosis in Brazil during the COVID-19 pandemic. Scientific Reports, v. 13, 23003, 2023. DOI: 10.1038/s41598-023-50359-y.
ARANTES, L. M. N. et al. Factors associated with late diagnosis of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in a university hospital in Brazil: challenges to achieving the 2030 target. Viruses, v. 15, n. 10, 2097, 2023. DOI: 10.3390/v15102097.
BRASIL. Ministério da Saúde. Boletim Epidemiológico HIV e Aids 2025. Brasília, DF: Ministério da Saúde, 2025.
BRASIL. Ministério da Saúde. Prevenção combinada do HIV. Brasília, DF: Ministério da Saúde, 2026.
BRASIL. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos: módulo 1, tratamento. Brasília, DF: Ministério da Saúde, 2024.
MARTINS, T. A. et al. Factors associated with late diagnosis of HIV/AIDS in Brazil. Revista da Escola de Enfermagem da USP, 2020.
REYES URUEÑA, J. et al. Late HIV diagnosis: trends, risk factors, and progress toward the 2025 target of less than 20% late diagnosis in 23 EU/EEA countries, 2022 to 2024. Eurosurveillance, v. 30, n. 47, 2025.
UNAIDS. AIDS, crisis and the power to transform: Global AIDS Update 2025. Geneva: Joint United Nations Programme on HIV/AIDS, 2025.
VLIEGENTHART JONGBLOED, K. J. et al. Strategies for improving HIV testing and detection rates in European hospitals: a systematic review. Microorganisms, v. 12, n. 2, 254, 2024. DOI: 10.3390/microorganisms12020254.
WORLD HEALTH ORGANIZATION. Consolidated guidelines on differentiated HIV testing services. Geneva: WHO, 2024.
WORLD HEALTH ORGANIZATION. Overview of WHO recommendations on HIV and sexually transmitted infection testing, prevention, treatment, care and service delivery. Geneva: WHO, 2025.
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