Risk factors for "late-to-test" HIV diagnosis in Riverside County, California.

Patients diagnosed late in the course of HIV infection are at an increased risk of negative health outcomes and are more likely to transmit HIV to others. Using the CDC's definition for AIDS, we analyzed case report data from persons diagnosed with AIDS within 12 months of an HIV diagnosis ("late-to-test") in Riverside County, CA, between 2009 and 2014. Of 1385 HIV cases, 422 (30.5%) were late-to-test. Factors associated with late-to-test were: having no insurance (P = 0.005), being Hispanic (P = 0.002) and being between 45 and 64 years of age (P < 0.001). Females (P = 0.013) and those in the eastern region of Riverside County (P = 0.002) were less likely to be late-to-test. In the absence of universal HIV testing, interventions to decrease late testing are needed.

Aging out in the desert: disclosure, acceptance, and service use among midlife and older lesbians and gay men.

Lesbian, gay, bisexual, and transgender (LGBT) persons in the county of Riverside, CA and in the Palm Springs/Coachella Valley area, in particular, responded to a questionnaire addressing concerns about identity disclosure and comfort accessing social services. Distributed at a Pride festival, as well as through religious, social, and service agencies, the final sample for analysis of 502 comprised 401 (80%) gay men and 101 (20%) lesbians in 4 groups: < 50 years of age (18%), 50 to 59 (26%), 60 to 69 (36%), and over 70 (20%). Results reveal that almost one-third of midlife and older gay men and lesbians maintain some fear of openly disclosing their sexual orientation. Along comparable lines with similar proportions, older gay men and lesbians maintain some discomfort in their use of older adult social services, even as the majority reports that they would feel more comfortable accessing LGBT-friendly identified services and programs. In both cases, lesbians reported greater fear and discomfort than did gay men; older gay men and lesbians reported that they would be less comfortable accessing LGBT-identified services and programs than did younger gay men and lesbians. These data support prior research on the apprehension of LGBT elders in accessing care, the crucial role of acceptance, with some suggestions of how social services might better prepare to address these needs.