Study focus area




Late presenters are more difficult to manage and have more medical complications than early presenters. In Sacco Hospital, 50% of new presenters are ‘late presenters’ (CD4<350/mm3), and over one third are ‘very late presenters’ (CD4<200/mm3). Algorithms have the potential to identify subjects at risk to becoming late presenters and could benefit from interventions to encourage HIV testing.

A black and white close-up of a senior man


The design of this study is a mixed methodology approach including quantitative clinical data, focus groups, and questionnaires. The primary end point is the percentage of general practitioners adopting the implemented algorithm. Secondary endpoints include the number of late presenters patients at Sacco Hospital 24-months post implementation, increased numbers HIV diagnosed patients identified & managed from at risk population in short term (1 year), a reduction in numbers of late presenters (long term) & increased cohort outcomes, a reduction in doctor pressure & overall cost of care (long term reduction per capita direct medical costs), a report of direct healthcare costs of late presenters, and a reduced risk of infection.

Primary objective

  • To develop and test an algorithm for identification of subjects at risk to become late presenters – this is based upon data of 200 late presenters in previous 5 years by analysis of their characteristics and pathways.
  • To identify & implement appropriate interventions to encourage HIV testing for patients at risk of being late presenters. The focus is upon general practitioner-based solutions.
  • Study the implementation, effectiveness and cost effectiveness of the intervention


Giuliano Rizzardini

Davide Croce


Asst Fatebenefratelli Sacco (Sacco Hospital)




Jul 2019 – Jul 2022


 Retention in Care and Adherence

Key study materials

ViiV study lead and contact

Duncan Short,
Director of Global Implementation Science




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As part of this project, financial incentives were used to engage and retain people living with HIV with the goal of contributing to viral suppression in the Baton Rouge, LA area.

Our partnerships

Our partnerships

We are proud to partner with multiple organizations that work to prevent HIV and improve the lives of people who live with HIV.

Find out more

NP-GBL-HVU-WCNT- 210047 | March 2022

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