Photo Credit: Md Ariful Islam

The following is a summary of “Implementing HIV teams to improve HIV indicator condition-guided testing in general practitioner centers in the Netherlands,” published in the December 2024 issue of Primary Care by Jordans et al. 

HIV testing for indicator conditions helps detect undiagnosed cases. General practitioners (GPs) often overlook testing despite recommendations. 

Researchers conducted a retrospective study to evaluate if HIV teams with trained GP ambassadors improved indicator condition-guided testing in urban Dutch GP centers 

They conducted a prospective implementation study (May 2021–March 2023) including patients ≥18 years newly diagnosed with HIV indicator conditions across 3 GP centers. Phase 1 involved HIV expert-led GP education and point-of-care testing, followed by phase 2 with peer-to-peer feedback by GP ambassadors. Questionnaires evaluated testing experiences and beliefs. Primary outcome was the HIV testing rate, and secondary outcomes included phase-specific testing rates, HIV positivity rate, and feedback. 

The results showed that among 132,338 visits, 846 (0.6%, 95%CI 0.6–0.7%) HIV indicator conditions were diagnosed, including 485 sexually transmitted infections (STIs) (57.3%). HIV testing was performed in 215 cases (25.4%) post-implementation, with similar rates in phases 1 and 2 (25.2% vs. 25.9%, P = 0.83) and pre- and post-implementation (21.3% vs 25.4%, P = 0.33). Testing was highest for unexplained weight loss (41.9%), lymphadenopathy (38.1%), and STIs (33.2%). About 3 patients (1.4%, 95%CI 0.3–4.0%) tested positive, with high patient acceptance and GP knowledge reported. 

Investigators found that implementing HIV teams did not improve testing rates in urban GP centers from low-prevalence settings. Despite high patient acceptance and GP knowledge, testing rates remained low. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02666-0