Auditing HIV testing rates across Europe: results from the HIDES 2 Study

Raben, D. and Mocroft, A. and Rayment, M. and Mitsura, V. M. and Hadziosmanovic, V. and Sthoeger, Z. M. and Palfreeman, A. and Morris, S. and Kutsyna, G. and Vassilenko, A. and Minton, J. and Necsoi, C. and Estrada, V. P. and Grzeszczuk, A. and Svedhem Johansson, V. and Begovac, Josip and Ong, E. L. C. and Cabié, A. and Ajana, F. and Celesia, B. M. and Maltez, F. and Kitchen, M. and Comi, L. and Dragsted, U. B. and Clumeck, N. and Gatell, J. and Gazzard, B. and d’Arminio Monforte, A. and Rockstroh, J. and Yazdanpanah, Y. and Champenois, K. and Jakobsen, M. L. and Sullivan, A. and Lundgren, J. D. (2015) Auditing HIV testing rates across Europe: results from the HIDES 2 Study. PLoS ONE, 10 (11). e0140845. ISSN 1932-6203

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Abstract

European guidelines recommend the routine offer of an HIV test in patients with a number of AIDS-defining and non-AIDS conditions believed to share an association with HIV; so called indicator conditions (IC). Adherence with this guidance across Europe is not known. We audited HIV testing behaviour in patients accessing care for a number of ICs. Participating centres reviewed the case notes of either 100 patients or of all consecutive patients in one year, presenting for each of the following ICs: tuberculosis, non-Hodgkins lymphoma, anal and cervical cancer, hepatitis B and C and oesophageal candidiasis. Observed HIV-positive rates were applied by region and IC to estimate the number of HIV diagnoses potentially missed. Outcomes examined were: HIV test rate (% of total patients with IC), HIV test accepted (% of tests performed/% of tests offered) and new HIV diagnosis rate (%). There were 49 audits from 23 centres, representing 7037 patients. The median test rate across audits was 72% (IQR 32-97), lowest in Northern Europe (median 44%, IQR 22-68%) and highest in Eastern Europe (median 99%, IQR 86-100). Uptake of testing was close to 100% in all regions. The median HIV+ rate was 0.9% (IQR 0.0-4.9), with 29 audits (60.4%) having an HIV+ rate >0.1%. After adjustment, there were no differences between regions of Europe in the proportion with >0.1% testing positive (global p = 0.14). A total of 113 patients tested HIV+. Applying the observed rates of testing HIV+ within individual ICs and regions to all persons presenting with an IC suggested that 105 diagnoses were potentially missed. Testing rates in well-established HIV ICs remained low across Europe, despite high prevalence rates, reflecting missed opportunities for earlier HIV diagnosis and care. Significant numbers may have had an opportunity for HIV diagnosis if all persons included in IC audits had been tested.

Item Type: Article
Additional Information: © 2015 Raben et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Departments: Katedra za infektologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Raben, D.UNSPECIFIED
Mocroft, A.UNSPECIFIED
Rayment, M.UNSPECIFIED
Mitsura, V. M.UNSPECIFIED
Hadziosmanovic, V.UNSPECIFIED
Sthoeger, Z. M.UNSPECIFIED
Palfreeman, A.UNSPECIFIED
Morris, S.UNSPECIFIED
Kutsyna, G.UNSPECIFIED
Vassilenko, A.UNSPECIFIED
Minton, J.UNSPECIFIED
Necsoi, C.UNSPECIFIED
Estrada, V. P.UNSPECIFIED
Grzeszczuk, A.UNSPECIFIED
Svedhem Johansson, V.UNSPECIFIED
Begovac, JosipUNSPECIFIED
Ong, E. L. C.UNSPECIFIED
Cabié, A.UNSPECIFIED
Ajana, F.UNSPECIFIED
Celesia, B. M.UNSPECIFIED
Maltez, F.UNSPECIFIED
Kitchen, M.UNSPECIFIED
Comi, L.UNSPECIFIED
Dragsted, U. B.UNSPECIFIED
Clumeck, N.UNSPECIFIED
Gatell, J.UNSPECIFIED
Gazzard, B.UNSPECIFIED
d’Arminio Monforte, A.UNSPECIFIED
Rockstroh, J.UNSPECIFIED
Yazdanpanah, Y.UNSPECIFIED
Champenois, K.UNSPECIFIED
Jakobsen, M. L.UNSPECIFIED
Sullivan, A.UNSPECIFIED
Lundgren, J. D.UNSPECIFIED
Date: 11 November 2015
Date Deposited: 11 Mar 2016 13:41
Last Modified: 11 Mar 2016 13:42
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2549

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