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Testing initiatives increase rates of HIV diagnosis in primary care and community settings: an observational single-centre cohort study.

Mahendran P, Soni S, Goubet S, Saunsbury E, Roberts J, Fisher M - PLoS ONE (2015)

Bottom Line: Single-centre observational cohort study.An outpatient HIV department in a secondary care UK hospital. 1359 HIV-infected adults.Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of GU Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.

ABSTRACT

Objectives: The primary objective was to examine trends in new HIV diagnoses in a UK area of high HIV prevalence between 2000 and 2012 with respect to site of diagnosis and stage of HIV infection.

Design: Single-centre observational cohort study.

Setting: An outpatient HIV department in a secondary care UK hospital.

Participants: 1359 HIV-infected adults.

Main outcome measures: Demographic information (age, gender, ethnicity, and sexual orientation), site of initial HIV diagnosis (Routine settings such as HIV/GUM clinics versus Non-Routine settings such as primary care and community venues), stage of HIV infection, CD4 count and seroconversion symptoms were collated for each participant.

Results: There was a significant increase in the proportion of new HIV diagnoses made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001). Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001). Diagnosis of recent infection increased from 23.0% to 47.1% (p=0.001). Of those with recent infection, significantly more patients were likely to report symptoms consistent with a seroconversion illness over the 13 years (17.6% to 65.0%; p<0.001).

Conclusions: This is the first study, we believe, to demonstrate significant improvements in HIV diagnosis and a shift in diagnosis of HIV from HIV/GUM settings to primary practice and community settings due to multiple initiatives.

No MeSH data available.


Related in: MedlinePlus

Non-Routine HIV diagnosis by location over time.Within the Non-Routine settings, a steady and significant increase in diagnoses was made within primary care and community settings.
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pone.0124394.g002: Non-Routine HIV diagnosis by location over time.Within the Non-Routine settings, a steady and significant increase in diagnoses was made within primary care and community settings.

Mentions: The location of diagnosis data is shown in Figs 1 and 2. This demonstrates a significant increase in the proportion of new HIV diagnoses being made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001), in particular, a steady and significant increase in diagnoses was made within primary care (2.7% to 21.2%; p<0.001). There was no significant change in the proportion of new diagnoses made in either medical inpatients or outpatients during the study time period.


Testing initiatives increase rates of HIV diagnosis in primary care and community settings: an observational single-centre cohort study.

Mahendran P, Soni S, Goubet S, Saunsbury E, Roberts J, Fisher M - PLoS ONE (2015)

Non-Routine HIV diagnosis by location over time.Within the Non-Routine settings, a steady and significant increase in diagnoses was made within primary care and community settings.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401513&req=5

pone.0124394.g002: Non-Routine HIV diagnosis by location over time.Within the Non-Routine settings, a steady and significant increase in diagnoses was made within primary care and community settings.
Mentions: The location of diagnosis data is shown in Figs 1 and 2. This demonstrates a significant increase in the proportion of new HIV diagnoses being made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001), in particular, a steady and significant increase in diagnoses was made within primary care (2.7% to 21.2%; p<0.001). There was no significant change in the proportion of new diagnoses made in either medical inpatients or outpatients during the study time period.

Bottom Line: Single-centre observational cohort study.An outpatient HIV department in a secondary care UK hospital. 1359 HIV-infected adults.Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of GU Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.

ABSTRACT

Objectives: The primary objective was to examine trends in new HIV diagnoses in a UK area of high HIV prevalence between 2000 and 2012 with respect to site of diagnosis and stage of HIV infection.

Design: Single-centre observational cohort study.

Setting: An outpatient HIV department in a secondary care UK hospital.

Participants: 1359 HIV-infected adults.

Main outcome measures: Demographic information (age, gender, ethnicity, and sexual orientation), site of initial HIV diagnosis (Routine settings such as HIV/GUM clinics versus Non-Routine settings such as primary care and community venues), stage of HIV infection, CD4 count and seroconversion symptoms were collated for each participant.

Results: There was a significant increase in the proportion of new HIV diagnoses made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001). Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001). Diagnosis of recent infection increased from 23.0% to 47.1% (p=0.001). Of those with recent infection, significantly more patients were likely to report symptoms consistent with a seroconversion illness over the 13 years (17.6% to 65.0%; p<0.001).

Conclusions: This is the first study, we believe, to demonstrate significant improvements in HIV diagnosis and a shift in diagnosis of HIV from HIV/GUM settings to primary practice and community settings due to multiple initiatives.

No MeSH data available.


Related in: MedlinePlus