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Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines

OBJECTIVES: To quantify the extent to which guideline recommendations for routine testing for HIV are adhered to outside of genitourinary medicine (GUM), sexual health (SH) and antenatal clinics. METHODS: A systematic review of published data on testing levels following publication of 2008 guideline...

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Detalles Bibliográficos
Autores principales: Elmahdi, Rahma, Gerver, Sarah M, Gomez Guillen, Gabriela, Fidler, Sarah, Cooke, Graham, Ward, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945742/
https://www.ncbi.nlm.nih.gov/pubmed/24412996
http://dx.doi.org/10.1136/sextrans-2013-051312
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author Elmahdi, Rahma
Gerver, Sarah M
Gomez Guillen, Gabriela
Fidler, Sarah
Cooke, Graham
Ward, Helen
author_facet Elmahdi, Rahma
Gerver, Sarah M
Gomez Guillen, Gabriela
Fidler, Sarah
Cooke, Graham
Ward, Helen
author_sort Elmahdi, Rahma
collection PubMed
description OBJECTIVES: To quantify the extent to which guideline recommendations for routine testing for HIV are adhered to outside of genitourinary medicine (GUM), sexual health (SH) and antenatal clinics. METHODS: A systematic review of published data on testing levels following publication of 2008 guidelines was undertaken. Medline, Embase and conference abstracts were searched according to a predefined protocol. We included studies reporting the number of HIV tests administered in those eligible for guideline recommended testing. We excluded reports of testing in settings with established testing surveillance (GUM/SH and antenatal clinics). A random effects meta-analysis was carried out to summarise level of HIV testing across the studies identified. RESULTS: Thirty studies were identified, most of which were retrospective studies or audits of testing practice. Results were heterogeneous. The overall pooled estimate of HIV test coverage was 27.2% (95% CI 22.4% to 32%). Test coverage was marginally higher in patients tested in settings where routine testing is recommended (29.5%) than in those with clinical indicator diseases (22.4%). Provider test offer was found to be lower (40.4%) than patient acceptance of testing (71.5%). CONCLUSIONS: Adherence to 2008 national guidelines for HIV testing in the UK is poor outside of GUM/SH and antenatal clinics. Low levels of provider test offer appear to be a major contributor to this. Failure to adhere to testing guidelines is likely to be contributing to late diagnosis with implications for poorer clinical outcomes and continued onwards transmission of HIV. Improved surveillance of HIV testing outside of specialist settings may be useful in increasing adherence testing guidelines.
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spelling pubmed-39457422014-03-10 Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines Elmahdi, Rahma Gerver, Sarah M Gomez Guillen, Gabriela Fidler, Sarah Cooke, Graham Ward, Helen Sex Transm Infect Health Services Research OBJECTIVES: To quantify the extent to which guideline recommendations for routine testing for HIV are adhered to outside of genitourinary medicine (GUM), sexual health (SH) and antenatal clinics. METHODS: A systematic review of published data on testing levels following publication of 2008 guidelines was undertaken. Medline, Embase and conference abstracts were searched according to a predefined protocol. We included studies reporting the number of HIV tests administered in those eligible for guideline recommended testing. We excluded reports of testing in settings with established testing surveillance (GUM/SH and antenatal clinics). A random effects meta-analysis was carried out to summarise level of HIV testing across the studies identified. RESULTS: Thirty studies were identified, most of which were retrospective studies or audits of testing practice. Results were heterogeneous. The overall pooled estimate of HIV test coverage was 27.2% (95% CI 22.4% to 32%). Test coverage was marginally higher in patients tested in settings where routine testing is recommended (29.5%) than in those with clinical indicator diseases (22.4%). Provider test offer was found to be lower (40.4%) than patient acceptance of testing (71.5%). CONCLUSIONS: Adherence to 2008 national guidelines for HIV testing in the UK is poor outside of GUM/SH and antenatal clinics. Low levels of provider test offer appear to be a major contributor to this. Failure to adhere to testing guidelines is likely to be contributing to late diagnosis with implications for poorer clinical outcomes and continued onwards transmission of HIV. Improved surveillance of HIV testing outside of specialist settings may be useful in increasing adherence testing guidelines. BMJ Publishing Group 2014-03 2014-01-10 /pmc/articles/PMC3945742/ /pubmed/24412996 http://dx.doi.org/10.1136/sextrans-2013-051312 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/
spellingShingle Health Services Research
Elmahdi, Rahma
Gerver, Sarah M
Gomez Guillen, Gabriela
Fidler, Sarah
Cooke, Graham
Ward, Helen
Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title_full Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title_fullStr Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title_full_unstemmed Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title_short Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines
title_sort low levels of hiv test coverage in clinical settings in the uk: a systematic review of adherence to 2008 guidelines
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945742/
https://www.ncbi.nlm.nih.gov/pubmed/24412996
http://dx.doi.org/10.1136/sextrans-2013-051312
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