How Successful Is the Push for Early HIV Diagnosis?

The first challenge of developing effective antiretroviral therapy was synthesizing the drugs; the second has been delivering them in time to prevent the ravages of AIDS. To this end, counseling and testing initiatives have been launched during the last decade, with the goal of identifying asymptomatic infected individuals and referring them for care. How successful have these initiatives been?

Baltimore investigators reasoned that one indicator of success would be progressively fewer patients presenting for initial care in the late, symptomatic stages of disease. However, they found just the reverse when they analyzed the presenting CD4-cell count and clinical status of more than 3000 treatment-naive patients who enrolled at Johns Hopkins–a…