“Late diagnosis is dangerous – and expensive to manage,” says Dr Ian Cormack, HIV consultant at Croydon University Hospital in south London.
“A year on antiretroviral therapy currently costs about £6000. The care bill for a recent patient who spent six weeks in our intensive care unit was well over £200,000, which would have been avoided if they’d tested a year before.”
In his experience, for some groups, late diagnosis remains the rule rather than the exception. “I’d say at least two-thirds of my current patients here had a CD4 count below the treatment-initiation limit of 350 cells/mm3 at diagnosis.
“My patient group here is two-thirds black African and I do know people from that group who have tested late either because they think HIV is still a death sentence, or are worried about their immigration status.”
But, he says, the people who really do scrape through – and the hospital had no avoidable HIV-related deaths last year, so scrape through they do – are the people who don’t fit the typical ‘high risk’ demographic, the 13% of his patients who aren’t openly gay men or black African people.
“The white heterosexuals are the most likely to turn up actually with AIDS-related symptoms. Them, and black Caribbeans, though we see a number of Asians too. They are often very ill and often have difficulties adjusting to their diagnosis, feeling especially isolated and stigmatised.”
