Amsterdam 2015
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| Abstract #2294 - Poster 1 | ||||
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Session: 58.16: Poster 1 (Poster) on Tuesday in Chaired by Authors: Presenting Author: Mr Ivo Joore - Academic Medical Center, Netherlands |
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| Additional Authors: Dr Kouassi Martin, Mr Brou Sylvain, | ||||
| Aim: The European Centre for Disease Prevention and Control recommends offering an HIV test to individuals who display HIV related diseases (HIV indicator conditions). The National Institute of Health and Care Excellence recommends performing ‘routine testing’ among all 15- to 59-year-olds in general practices where HIV prevalence exceeds 2 in 1000. “Routine HIV testing” involves offering an HIV test to new patients during registration, and to anyone undergoing a laboratory blood test, regardless of the indication. Implementation of new additional HIV testing strategies however is limited, while the numbers of undiagnosed HIV patients remain high. We aimed to discuss general practitioners (GPs) barriers and facilitators towards both strategies. | ||||
| Method / Issue: We combined semi-structured in-depth interviews with focus groups. Nine GPs that were familiar with STI/HIV prevention were ed for the interviews. We organised focus groups with a general sample of GPs (n=81). Framework analysis was used to analyse the data. | ||||
| Results / Comments: Different barriers were found for both strategies (1) towards the content: testing the right target group and other competing priorities in general practice, (2) towards organisational implementation: lack of time, unclear when to repeat the HIV test and the list of indicator conditions is too long, and (3) patient-related barriers: creating fear among patients, stigmatizing them and patients have to pay a fixed amount of money out of their pocket. The majority of GPs mentioned that performing a risk-assessment in patients is important before applying both strategies. They think you should use sexual history as a guiding principle. Also, other facilitators were mentioned: (1) adding age-restrictions to frequently diagnosed indicator conditions, (2) combining the indicator-guided approach in a high prevalence area might be more beneficial, and (3) combining the HIV test with other screening blood tests, related to cardiovascular risk factors, might be a way to implement the routine-testing approach. | ||||
| Discussion: GPs need to be aware about the philosophy behind both additional strategies that try to avoid some of the barriers that GPs encounter during a risk-assessment. Creating more awareness that risk-based testing has intrinsic limitations and is not sufficient in reducing the number of undiagnosed HIV patients is also an important step for actual implementation of both strategies. | ||||
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