Trends and associated factors of late-stage HIV diagnosis among heterosexuals in the Netherlands between 2012 and 2022: An analysis of national surveillance data.

OBJECTIVES

Late-stage HIV diagnoses among heterosexuals remain a problem in Europe, yet little is known about its risk factors. We aimed to identify the trends and factors associated with late-stage HIV diagnosis among heterosexuals in the Netherlands.

METHODS

We used national HIV surveillance data and included individuals diagnosed between 2012 and 2022, with heterosexual contact as the suspected transmission route. We applied descriptive statistics and logistic regression analyses.

RESULTS

Of 1637 HIV diagnoses among heterosexuals, 932 (57%) were late-stage disease. The proportion of late-stage diagnoses was stable during 2012-2022 (range 51-62%). Significant risk factors for late-stage diagnosis were male sex (adjusted odds ratio [AOR] = 1.72; 95% confidence interval [CI] = 1.40-2.13), older age (every 10-year increase: AOR = 1.48; 95% CI = 1.34-1.62), being born in Africa (AOR = 2.21; 95% CI = 1.70-2.88), and Asia (AOR = 2.93; 95% CI = 1.88-4.65). People born in eastern Europe approached significance (AOR = 1.70; 95% CI = 0.97-3.05). Most late-stage diagnoses occurred in hospitals.

CONCLUSIONS

The proportion of late-stage HIV diagnoses remains high among heterosexuals in the Netherlands. Men; older people; and those born in Africa, Asia, and eastern Europe were associated with late-stage diagnosis.