Improving indicator-condition guided testing for HIV in the hospital setting (PROTEST 2·0): A multicenter,...

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Medicine

Background:

• Indicator-condition (IC) guided HIV testing is a cost-effective strategy to find undiagnosed people living with HIV (PLHIV).
• Implementation of IC-guided HIV testing remains suboptimal.
• This study aimed to enhance IC-guided HIV testing across seven specific indicator conditions.

Purpose of the Study:

• To evaluate the effectiveness of a multifaceted intervention designed to promote IC-guided HIV testing.
• To assess the impact of the intervention on HIV testing rates within a specific timeframe around IC diagnosis.
• To identify variations in intervention effectiveness across different indicator conditions.

Main Methods:

• A quasi-experimental study was conducted in five Amsterdam region hospitals.
• Electronic health records were used to assess HIV testing rates in adult patients with an IC before and after the intervention.
• The intervention involved audit and feedback, and data were analyzed using segmented Poisson regression.

Main Results:

• The proportion of patients tested for HIV within three months of IC diagnosis increased from 36.8% to 47.0% (adjusted RR=1.16).
• Significant increases in HIV testing were observed for cervical cancer and peripheral neuropathy.
• A total of 18 HIV-positive cases were identified (0.6% of tested patients).

Conclusions:

• The intervention successfully improved overall IC-guided HIV testing rates.
• The effectiveness of the intervention varied across different indicator conditions.
• Further research is needed to understand and address the variations in intervention impact.