By the same authors

From the same journal

From the same journal

Journeys to HIV testing and diagnosis among adults aged 50+ years in England: a qualitative interview study

Research output: Contribution to journalArticlepeer-review



Publication details

JournalJournal of Health Services Research & Policy
DateAccepted/In press - 24 Jun 2020
DateE-pub ahead of print (current) - 2 Dec 2020
Early online date2/12/20
Original languageEnglish


In England, older adults (aged ≥50 years) are at greater risk of being diagnosed with advanced stage HIV infection than younger adults. We explored journeys to testing and diagnosis among older adults, examining factors associated with late HIV diagnosis in this age group.

Semi-structured qualitative interviews were performed with 12 adults diagnosed with HIV at age 50+ years and 12 health care professionals working in sexual health/HIV services. Data were analysed thematically, using the Model of Pathways to Treatment as a framework for analysis.

Older adults were often found to experience non-linear and complex diagnostic journeys. Pathways to diagnosis were affected by 6 factors: (i) the non-specific nature of HIV symptoms and their misattribution as being age-related; (ii) symptom severity, impact, and visibility; (iii) HIV health literacy; (iv) perceptions of HIV risk; (v) geographical location; and (vi) assessment in non-specialist settings.

Older adults appear to encounter additional barriers to HIV testing compared with younger people, particularly when they are not part of a group targeted in HIV prevention and testing campaigns. To diagnose HIV more promptly in adults aged 50+ years, HIV knowledge and risk perception must increase in both older people and health care professionals. Health care professionals need to look beyond the ‘high risk’ groups that are most affected by HIV and consider HIV more readily in the diagnostic process.

Keywords HIV, older people, HIV testing

Bibliographical note

© The Author(s) 2020

Discover related content

Find related publications, people, projects, datasets and more using interactive charts.

View graph of relations