The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care

BMC Family Practice

Research Article

Ivo K. Joore¹  Jan E. A. M. van Bergen²  Suzanne E. Geerlings³  Ann M. Vanrolleghem⁴  Maria de Ridder⁴  Denise E. Twisk⁵  Ingrid V. van den Broek⁵ 

[1] Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;STI AIDS Netherlands (SOA AIDS Nederland), Amsterdam, The Netherlands;Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands;Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands;National Institute for Public Health and the Environment (RIVM), Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, Bilthoven, The Netherlands;

关键词: Case-control studies;    General practice;    HIV infections/prevention & control;    HIV infections/epidemiology;    Primary healthcare;   

DOI  :  10.1186/s12875-016-0556-2

 received in 2016-04-14, accepted in 2016-11-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEuropean guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis.MethodsWe did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis.ResultsWe included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy.ConclusionsOur study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs’ future guidelines and that education strategies be used to facilitate its implementation in daily practice.

【 授权许可】

CC BY   
© The Author(s). 2016