Late presentation continues to be a problem for patents with HIV disease. Failure to diagnose HIV seroconversion at early stage can occur for a number of reasons.
Psychological barriers:
(1) fear (fear of illness, fear of death, in denial)
(2) stigma surrounding testing for HIV and living with a positive diagnosis
(3) failure to ask contacts about their HIV status
Perception of low risk:
(1) low self-perceived low risk for contracting HIV
(2) failure to identify with MSM community or failure to disclose MSM activities
(3) older age and heterosexual
(4) unaware of risk (including behavior of spouse)
Lack of adequate healthcare:
(1) homeless
(2) migrant
(3) unemployed
(4) substance abuse
(5) not in a population included in a screening protocol
(6) healthcare services not being active enough in doing testing
