HIV testing within general practices in Europe: a mixed-methods systematic review.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Primary Care Medicine

Background:

• Late diagnosis of HIV infection is a significant challenge in Europe.
• General practitioners (GPs) are crucial for early HIV case finding, but many diagnostic opportunities are missed.
• A systematic review was conducted to synthesize evidence on HIV testing in primary care.

Purpose of the Study:

• To describe HIV testing practices in European general practices.
• To identify barriers and facilitators influencing HIV testing by GPs.
• To inform strategies for promoting HIV testing in primary care.

Main Methods:

• A mixed-methods systematic review of 29 studies.
• Searches conducted in PubMed, Scopus, and Embase databases (2006-2017).
• Independent eligibility assessment by two authors.

Main Results:

• Most HIV tests in general practice are performed upon patient request.
• Barriers include lack of communication skills, knowledge gaps regarding recommendations and epidemic specifics, difficulties with clinical indicator diseases, and challenges in result delivery.
• Training, practical tools, and promotional programs positively impact GP testing performance.

Conclusions:

• GPs can enhance their role in provider-initiated HIV testing for early detection.
• Addressing identified barriers and adapting testing criteria for primary care are essential.
• Guidance, training on priority groups, and information on HIV epidemic characteristics are fundamental to increasing GP awareness and testing.