Recent guidelines advocate accelerated provider-initiated
HIV testing by general practitioners (GPs). We aimed to identify the number of
patient consultations in six general practices in the South-East of Amsterdam,
and the incidence of HIV indicator conditions reported in their medical files
prior to diagnosis.
A cross-sectional search in an electronic general practice
database. We used a case–control design to identify those conditions most
associated with an HIV-positive status.
We included 102 HIV cases diagnosed from 2002 to 2012, and
matched them with 299 controls. In the year prior to HIV diagnosis, 61.8% of
cases visited their GP at least once, compared with 38.8% of controls. In the
5 years prior to HIV diagnosis, 58.8% of HIV cases had exhibited an HIV
indicator condition, compared with 7.4% of controls. The most common
HIV-related conditions were syphilis and gonorrhoea. The most common
HIV-related symptoms were weight loss, lymphadenopathy and peripheral
neuropathy. During this period, average HIV prevalence among people aged
15–59 years increased from 0.4% to 0.9%.
This study revealed many opportunities for HIV indicator
condition-guided testing in primary care. As yet, however, HIV indicator
conditions are not exploited as triggers for early HIV testing.
Below: Trends in prevalence of HIV in six general practices in a South-Eastern district of Amsterdam, the Netherlands, 2002–2012
Full article
at:
By:
1 Department of General Practice, Division of Clinical Methods and
Public Health, Academic Medical Center, Amsterdam, The Netherlands
2 Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The
Netherlands
4 Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of
Public Health and the Environment (RIVM), Bilthoven, The
Netherlands
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