Improving access to HIV testing in the community
Providing point-of-care (POCT) testing clinics in primary care broadens the availability of HIV testing in the community and attracts different types of patients, a practice-based study has found.
An audit compared the use of HIV POCT clinics in a general practice and a GUM clinic in South London, over the same period, using retrospective case-note review.
Patients of black ethnicity were more likely to use the POCT clinic than the GUM one. Respective usage rates were: Black African 16.5% vs 8.7%; Black Caribbean 5.1% vs 0.9%; Black Other 5.4% vs 2.1%). However, fewer men who have sex with men attended the POCT clinic than the GUM clinic (34.5% vs 41.3%).
The authors conclude that POCT for HIV appears to attract a different ‘at-risk' group and provides increased opportunity for testing.
Black ethnicity is often associated with late diagnosis of HIV. Increasing access to HIV testing especially in the primary care setting should reduce incidence of late diagnoses and therefore, increase the effectiveness of antiretroviral therapies.
A recent communication from the CMO recommended increasing awareness of HIV testing in the population in order to reduce the incidence of late diagnoses.
A national audit reported that around one quarter of HIV diagnoses occurred too late for effective treatment and late diagnoses accounted for at least 35% of HIV-related deaths. Many of these patients presented to their GP before diagnosis. Therefore, increased access to HIV testing in general practice could help reduce the pool of undiagnosed HIV.
Surah S, O'Shea S, Dunn H. et al Utilisation of HIV point-of-care testing clinics in general practice and genitourinary medicine services in South-East London. Int J STD & AIDS 2009;20:168-169Reviewer
Dr Richard Ma
GP Principal, North London and staff grade in sexual and reproductive health, Margaret Pyke Centre, London