Academic Journal
Missed opportunities for HIV testing among patients newly presenting for HIV care at a Swiss university hospital: a retrospective analysis
| Title: | Missed opportunities for HIV testing among patients newly presenting for HIV care at a Swiss university hospital: a retrospective analysis |
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| Authors: | Loïc Lhopitallier, Estelle Moulin, Olivier Hugli, Matthias Cavassini, Katharine Elizabeth Anna Darling |
| Source: | BMJ Open BMJ open, vol. 8, no. 6, pp. e019806 |
| Publisher Information: | BMJ, 2018. |
| Publication Year: | 2018 |
| Subject Terms: | Adult, Male, Delayed Diagnosis, Adolescent, Africa South of the Sahara/ethnology, Aged, Ambulatory Care, Delayed Diagnosis/statistics & numerical data, Female, HIV Infections/diagnosis, HIV Infections/ethnology, Homosexuality, Male/statistics & numerical data, Hospitals, University, Humans, Logistic Models, Mass Screening/methods, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Factors, Switzerland, Young Adult, Hiv diagnosis, Hiv indicator conditions, Hiv testing, late presenters, missed opportunities, HIV Infections, 3. Good health, HIV/AIDS, Mass Screening, Homosexuality, Male, Africa South of the Sahara |
| Description: | ObjectivesTo determine the frequency of missed opportunities (MOs) among patients newly diagnosed with HIV, risk factors for presenting MOs and the association between MOs and late presentation (LP) to care.DesignRetrospective analysis.SettingHIV outpatient clinic at a Swiss tertiary hospital.ParticipantsPatients aged ≥18 years newly presenting for HIV care between 2010 and 2015.MeasuresNumber of medical visits, up to 5 years preceding HIV diagnosis, at which HIV testing had been indicated, according to Swiss HIV testing recommendations. A visit at which testing was indicated but not performed was considered an MO for HIV testing.ResultsComplete records were available for all 201 new patients of whom 51% were male and 33% from sub-Saharan Africa. Thirty patients (15%) presented with acute HIV infection while 119 patients (59%) were LPs (CD4 counts 3at diagnosis). Ninety-four patients (47%) had presented at least one MO, of whom 44 (47%) had multiple MOs. MOs were more frequent among individuals from sub-Saharan Africa, men who have sex with men and patients under follow-up for chronic disease. MOs were less frequent in LPs than non-LPs (42.5% vs 57.5%, p=0.03).ConclusionsAt our centre, 47% of patients presented at least one MO. While our LP rate was higher than the national figure of 49.8%, LPs were less likely to experience MOs, suggesting that these patients were diagnosed late through presenting late, rather than through being failed by our hospital. We conclude that, in addition to optimising provider-initiated testing, access to testing must be improved among patients who are unaware that they are at HIV risk and who do not seek healthcare. |
| Document Type: | Article Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2017-019806 |
| Access URL: | https://bmjopen.bmj.com/content/bmjopen/8/6/e019806.full.pdf https://pubmed.ncbi.nlm.nih.gov/29895647 https://www.ncbi.nlm.nih.gov/pubmed/29895647 https://pubmed.ncbi.nlm.nih.gov/29895647/ https://bmjopen.bmj.com/content/8/6/e019806.full.pdf http://bmjopen.bmj.com/content/8/6/e019806 https://bmjopen.bmj.com/content/8/6/e019806 https://europepmc.org/articles/PMC6009466 https://serval.unil.ch/notice/serval:BIB_BCCD5FE237CB https://serval.unil.ch/resource/serval:BIB_BCCD5FE237CB.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_BCCD5FE237CB2 |
| Rights: | CC BY NC |
| Accession Number: | edsair.doi.dedup.....dde982c89cefa40a8b34be5fb2d7315d |
| Database: | OpenAIRE |
| ISSN: | 20446055 |
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| DOI: | 10.1136/bmjopen-2017-019806 |