Systematic Review: Strategies for Improving HIV Testing and Detection Rates in European Hospitals

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Healthcare Management

Background:

• Undiagnosed HIV infection remains a significant public health concern in Europe, necessitating improved testing and diagnosis.
• Missed testing opportunities and delayed diagnoses contribute to the spread of HIV and poorer patient outcomes.
• European healthcare professionals and policymakers must address HIV testing challenges.

Purpose of the Study:

• To systematically review interventions aimed at increasing HIV testing rates and case detection in European hospitals.
• To evaluate the effectiveness of different HIV testing strategies, including test-all and indicator-condition-based approaches.
• To identify gaps in current knowledge regarding the generalizability and sustainability of these interventions.

Main Methods:

• A systematic review of 4598 identified articles was conducted.
• 29 studies meeting the selection criteria were analyzed.
• Interventions primarily focused on test-all and indicator-condition-based testing strategies.

Main Results:

• The prevalence of undiagnosed HIV was consistently above 0.1% across studies.
• Interventions successfully increased both HIV testing rates and case detection rates.
• Indicator-condition-driven testing identified the highest prevalence of undiagnosed HIV, while test-all strategies reduced late diagnoses.

Conclusions:

• Effective strategies to enhance HIV testing in European hospitals exist.
• Significant knowledge gaps remain concerning the generalizability and sustainability of these interventions across diverse European regions.
• Further research and adherence to HIV testing guidelines are crucial for improving HIV case finding and reducing late diagnoses.