HIV testing in medical admissions is a missed opportunity

Alston, Claire; Moffatt, Daisy; Asherson, Andrew P; Powell, Natalie; Narouz, N

doi:10.7861/clinmedicine.13-1-114

Cited by 2 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with research which indicates increased normalization of testing [20]. Nevertheless, clinical audits suggest that there remain missed opportunities for testing among both general medical admissions [8] and patients in general practice [10,11]. The results of this audit confirm that routine HIV testing in these settings has been commissioned in only a minority of high-prevalence areas, and prioritizing the introduction of routine testing in these settings will be necessary to fully implement national testing guidelines.…”

Section: Discussionsupporting

confidence: 82%

“…Following the publication of the guidelines, it is not clear to what extent they have been implemented on a national level. While there is some evidence that an increasing proportion of tests are taking place outside of traditional settings, particularly in general practice , this has been from a low starting point and there are likely to remain missed opportunities for testing in nonspecialist medical settings .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Expanded HIV testing in high‐prevalence areas in England: results of a 2012 audit of sexual health commissioners

et al. 2013

View full text Add to dashboard Cite

The aim of the study was to examine whether UK HIV testing guidelines which recommend the expansion of HIV testing in high HIV prevalence areas have been implemented in England. MethodsAn online survey tool was used to conduct an audit of sexual health commissioners in 40 high HIV prevalence areas (diagnosed prevalence > 2 per 1000) between May and June 2012. Responders were asked to provide details of expanded HIV testing programmes that they had commissioned in nontraditional settings and perceived barriers and facilitators involved in introducing expanded testing. ResultsThe response rate was 88% (35 of 40). Against the key audit standards, 31% (11 of 35) of areas had commissioned routine testing of new registrants in general practice, and 14% (five of 35) routine testing of general medical admissions. The majority of responders (80%; 28 of 35) had commissioned some form of expanded testing, often targeted at risk groups. The most common setting for commissioning of testing was the community (51%; 18 of 35), followed by general practice (49%; 17 of 35) and hospital departments (36%; 13 of 35). A minority (11%; four of 35) of responders had commissioned testing in all three settings. Where testing in general practice took place this was typically in a minority of practices (median 10-20%). Most (77%; 27 of 35) expected the rate of HIV testing to increase over the next year, but lack of resources was cited as a barrier to testing by 94% (33 of 35) of responders. ConclusionsNot all high HIV prevalence areas in England have fully implemented testing guidelines. Scale-up of existing programmes and continued expansion of testing into new settings will be necessary to achieve this.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Expanded HIV testing in high‐prevalence areas in England: results of a 2012 audit of sexual health commissioners

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Barriers to testing for HIV perceived by frontline staff were not investigated in this study, but feedback revealed factors similar to previous studies: HIV stigma [ 36 ], variability of uptake amongst consultants [ 17 ], inadequate financial and workforce infrastructure [ 37 ], and perceived inadequate skill set [ 20 ]. The last factor was particularly apparent during the junior doctor teaching sessions, and it has been shown that despite HIV medicine being on the 2009 national core curriculum, over two-thirds of junior doctors still feel they need further training to confidently test for HIV [ 28 , 38 ].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Opt-out routine testing rates in “traditional” settings such as sexual health and ante-natal clinics have increased substantially since the UKNG [ 15 ]. There has also been some success in other “non-traditional” settings in the UK and Europe [ 16 – 28 ] (see Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Four-Stage Audit Demonstrating Increased Uptake of HIV Testing in Acute Neurology Admissions Using Staged Practical Interventions

et al. 2015

View full text Add to dashboard Cite

BackgroundUK National Guidelines (UKNG) advise HIV testing in clinically indicated neurological presentations. We audited the impact of our practical strategies to increase uptake of HIV testing at a regional acute neurology admissions unit.MethodsWe audited HIV testing in 4 periods over 2 years: before we designed a UKNG-based “HIV testing in Neurology” protocol (“pre-protocol”); after dissemination of the protocol alone (“post-protocol”); post-protocol dissemination combined with both a tailored departmental admissions clerking proforma to prompt for HIV testing & consenting, and regular focussed tutorials to doctors on HIV testing in neurological patients (“post-proforma”); and finally one year after the post-proforma period (“+1 year”). We also looked at the total number of HIV tests sent from the unit during the two-year period. We assessed significance using Fisher’s exact test.Results47.8% of all acute neurology non-stroke admissions were eligible for HIV testing during all the audit periods. Testing rates were as follows: pre-protocol 21.9%; post-protocol 36.6%; post-proforma 83.3%; and at +1 year 65.4% (p<0.05 for both post-protocol and +1 year when compared to pre-protocol). Documentation of consent for HIV testing improved from 25% to 67.6% with the HIV-tailored clerking proforma. The total number of HIV tests requested from the unit doubled in the post-proforma period compared to pre-protocol (p<0.05).ConclusionIn conclusion: the combination of an HIV testing protocol, a tailored departmental clerking proforma and regular focussed teaching to doctors on indications for HIV testing led to a sustained increase in HIV testing uptake in our regional acute neurology admissions unit.

show abstract

HIV testing in medical admissions is a missed opportunity

Cited by 2 publications

References 0 publications

Expanded HIV testing in high‐prevalence areas in England: results of a 2012 audit of sexual health commissioners

Expanded HIV testing in high‐prevalence areas in England: results of a 2012 audit of sexual health commissioners

Four-Stage Audit Demonstrating Increased Uptake of HIV Testing in Acute Neurology Admissions Using Staged Practical Interventions

Contact Info

Product

Resources

About