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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

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Promoting HIV indicator condition-guided testing in hospital settings (PROTEST 2.0): study protocol for a multicentre

Saskia J Bogers¹, Maarten F Schim van der Loeff^2,3, Udi Davidovich³

¹Department of Internal Medicine, Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, room D3-226, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. s.j.bogers@amsterdamumc.nl.

BMC Infectious Diseases

|June 3, 2021

Summary

Late HIV diagnosis is a major challenge. This study aims to increase HIV testing in patients with indicator conditions (ICs) through an educational intervention in Amsterdam hospitals, improving early detection and treatment.

Keywords:

HIV testing Healthcare quality improvement Implementation Indicator condition Multifaceted intervention

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Last Updated: Nov 3, 2025

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Published on: October 31, 2010

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Area of Science:

Infectious Diseases
Public Health
Clinical Medicine

Background:

Late presentation of Human Immunodeficiency Virus (HIV) infection hinders epidemic control.
Indicator Conditions (ICs) are crucial for identifying undiagnosed HIV, but testing opportunities are often missed.
Hospital-based HIV testing strategies are essential for early diagnosis.

Purpose of the Study:

To implement and evaluate an interventional study to enhance awareness and uptake of HIV testing guided by Indicator Conditions (ICs).
To increase HIV testing rates among patients presenting with specific ICs in a hospital setting.
To reduce late diagnoses and improve the management of HIV in Amsterdam.

Main Methods:

A multicentre interventional study conducted in five Amsterdam hospitals.
Baseline assessment of HIV test ratios and qualitative/quantitative evaluation of barriers and facilitators.
An educational intervention involving audit and feedback, followed by post-intervention assessment of HIV test ratios.

Main Results:

The study protocol outlines the measurement of HIV test ratios within 3 and 6 months of IC diagnosis.
Secondary endpoints include HIV positivity, proportion of late presenters, and prior HIV status knowledge.
The intervention aims to improve the HIV test ratio, a key performance indicator.

Conclusions:

This protocol details a strategy to boost awareness and utilization of IC-guided HIV testing in hospitals.
The intervention is designed to increase the identification of undiagnosed HIV cases in Amsterdam.
Improving early HIV diagnosis through IC-guided testing is critical for public health.