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STI clinic attendees have high HIV diagnosis rates in Netherlands, but many missed opportunities in primary care
Gus Cairns, 2015-09-02 08:00:00
Two studies from the Netherlands show that while the proportion of people with HIV who are diagnosed has improved in recent years, the Netherlands lags behind some other western European countries in its HIV diagnosis rate, which has not improved at all in some groups.
Diagnosis rates in 2012 were high in gay men and other men who have sex with men (MSM - only 14% of those with HIV undiagnosed) and non-migrant heterosexuals (16% undiagnosed) who attended STI clinics. However they were considerably lower among MSM who did not visit STI clinics (about 35% undiagnosed), among African migrants visiting STI clinics (46% undiagnosed) and among migrants who did not visit STI clinics (about 50% undiagnosed).
The lowest rates of diagnosis were in female sex workers (FSWs), in whom two-thirds of those with HIV did not know they had it. The researchers comment that this is often because FSWs are undocumented or otherwise hard-to-reach immigrants who may only stay in the Netherlands for a short time.
A second study, of people attending six primary care practices in Amsterdam, found that the majority of people eventually diagnosed with HIV had attended their GP more than once in the year before their diagnosis and had more appointments and blood tests than a control group of matched patients who were not HIV positive. They were also vastly more likely than control patients, in the five years before diagnosis, to have been diagnosed with a sexually transmitted infection (STI) or at least one of a list of HIV-related diseases and symptoms. The most common single condition associated with subsequent HIV diagnosis was unexplained weight loss.
The researchers of this paper say that “there is an urgent need to identify the barriers and facilitators that affect effective implementation by GPs…of HIV indicator condition-guided testing in primary care.”
Source:1
