The importance of registration of sexual orientation and recognition of indicator conditions for an adequate HIV risk-assessment

BMC Infectious Diseases

Research Article

Ivo K. Joore¹  Jan E. A. M. van Bergen²  Jan M. Prins³  Suzanne E. Geerlings³  Kees Brinkman⁴ 

[1] Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Meibergdreef 9, 1100 DE, Amsterdam, 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 Internal Medicine, OLVG, Amsterdam, The Netherlands;

关键词: Human Immunodeficiency Virus;    Sexual Orientation;    Human Immunodeficiency Virus Testing;    General Practitioner;    Human Immunodeficiency Virus Prevalence;   

DOI  :  10.1186/s12879-017-2279-y

 received in 2016-11-16, accepted in 2017-02-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHIV testing among risk groups and guided by HIV indicator conditions (IC) is widely recommended by European guidelines. In this study we investigated how these strategies are used by general practitioners (GP) and in other healthcare settings. The objectives of our study were to describe: 1) the proportion of consultations in primary care and other healthcare settings in the five years prior to diagnosis; 2) patient and GP perspectives on the primary healthcare providers’ awareness and registration of sexual orientation and ethnicity in the electronic medical record (EMR); and 3) the proportion of HIV-infected patients who had been diagnosed with an IC prior to HIV diagnosis.MethodsA survey study (2014–2016) was conducted among newly diagnosed HIV-infected patients presenting at two HIV outpatient clinics in Amsterdam. We collected information on the number of consultations and extent of HIV testing in healthcare settings in the 5 years prior to HIV diagnosis; on patient and GP perspectives on the primary healthcare providers’ awareness of sexual orientation and ethnicity; and on preselected ICs and symptoms of acute HIV infection prior to diagnosis. GPs were also approached for further information.ResultsIn the 5 years prior to HIV diagnosis, 82.9% of the 111 patients had one or more consultations with their GP, but only 34.8% had one or more HIV tests performed in general practice during this period. In more than 50% of cases the patients took the initiative for the positive HIV test. GPs stated that they were aware of the sexual orientation of 59.6% of their patients who were men who have sex with men (MSM); however, sexual orientation was only documented in the EMR in 34.0% of these cases. GPs also reported that they were aware that a patient was from an HIV endemic country in more than half of the cases. GPs diagnosed 48.3% of all ICs and 39.5% of this group was offered an HIV test at that time.ConclusionsDocumentation of sexual orientation and ethnicity, and IC-guided testing by GPs could be the starting point for more proactive provider-initiated HIV testing.

【 授权许可】

CC BY   
© The Author(s). 2017