BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit

Area of Science:

• Public Health
• Sexual Health
• Clinical Audit

Background:

• Discrepancies exist between stated clinic policies and actual practices for screening substance use and sexual risk behaviors.
• HIV testing uptake and reasons for refusal require further investigation within sexual health services.

Purpose of the Study:

• To audit current practices in sexual health clinics regarding inquiries about alcohol, recreational drug, and chemsex use.
• To identify barriers to HIV testing and assess the frequency of testing among men who have sex with men (MSM).

Main Methods:

• A national audit of sexual health clinics was conducted.
• Data were collected on clinic policies, routine practices for risk behavior inquiries, and reasons for HIV test refusal.

Main Results:

• Clinics were more likely to inquire about risk behaviors when it was part of their policy or routine.
• Previous HIV testing was the most common reason for refusal, with 33% of MSM having not been tested in over three months.
• A significant proportion of individuals declining testing due to the 'window period' had recent exposures not covered by prior testing.

Conclusions:

• There is a need for standardized risk assessments for substance use and chemsex.
• Improving documentation of HIV test refusal and offering point-of-care HIV testing are recommended.
• Enhanced follow-up for high-risk individuals and promotion of community-based or self-testing options are crucial for early HIV detection.