Late diagnosis, delayed presentation and late presentation in HIV: proposed definitions, methodological considerations and health implications

Contemporary literature emphasizes HIV treatment across multiple stages of the care continuum, beginning with HIV testing, followed by linkage and retention in medical care. As a sizeable global population remains undiagnosed or not engaged in medical care, researchers must evaluate the earliest phases of the HIV treatment cascade in order to optimize individual health outcomes and treatment-as-prevention initiatives. Because ambiguity persists for classification of these early stages of HIV care, the aim of this review is to propose a congruous approach to defining the constructs of late diagnosis, delayed presentation and late presentation for HIV medical care, as well as focus attention on methodological considerations and associated clinical and public health implications for these entities.