Auditing HIV Testing Rates across Europe: Results from the HIDES 2 Study

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• European guidelines advocate routine HIV testing for patients with specific indicator conditions (ICs) associated with HIV.
• Adherence to these HIV testing guidelines across Europe is not well-documented.

Purpose of the Study:

• To audit HIV testing practices in patients presenting with indicator conditions across various European regions.
• To estimate the number of potentially missed HIV diagnoses due to low testing rates.

Main Methods:

• Retrospective audit of 7037 patient case notes from 23 centers across Europe, focusing on tuberculosis, lymphoma, cancers, hepatitis B/C, and oesophageal candidiasis.
• Analysis of HIV test rates, uptake, and new HIV diagnosis rates.
• Estimation of missed HIV diagnoses based on observed testing and positivity rates.

Main Results:

• Median HIV testing rate was 72%, with significant regional variation (Northern Europe 44% vs. Eastern Europe 99%).
• HIV uptake was nearly 100% where tests were offered.
• A median HIV-positive rate of 0.9% was observed, with 60.4% of audits showing >0.1% positivity.
• An estimated 105 HIV diagnoses may have been missed across the audited indicator conditions.

Conclusions:

• HIV testing rates for established indicator conditions remain suboptimal across Europe.
• Low testing rates represent missed opportunities for early HIV diagnosis and treatment.
• Standardized auditing is crucial to monitor and improve adherence to HIV testing guidelines for indicator conditions.