| Autor: |
Kaide E; Genitourinary Medicine Department, 159020Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK., Curtis H; 454779British HIV Association, London, UK., Freedman A; 97609Cardiff University School of Medicine/University Hospital of Wales, Cardiff, UK., Croxford S; 574630Public Health England (PHE) Blood Safety Hepatitis Sexually Transmitted Infections and HIV Division National Infection Service, London, UK., Burns F; Institute for Global Health, 4919University College London, London, UK.; 4965Royal Free London NHS Foundation Trust, London, UK., Sabin C; Institute for Global Health, 4919University College London, London, UK.; 130346National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL, London, UK., Chadwick DR; Centre for Clinical Infection, 156705James Cook University Hospital, Middlesbrough, UK., Sullivan A; 9762Chelsea and Westminster Hospital NHS Foundation Trust, London, UK. |
| Abstrakt: |
The British HIV Association recommends that new diagnoses be reviewed by an HIV specialist within two weeks. NHS England outcome measures include the proportion of new diagnoses commencing antiretroviral therapy (ART) within 91 days. We aimed to review the extent to which these recommendations were followed, to explore the topics discussed with new diagnoses, and to identify reasons behind delayed ART initiation. UK specialist HIV services were invited to retrospectively review the notes of their last 40 new diagnoses over a 15-month period. One-hundred and thirty-two services provided data for 2281 eligible individuals. Most new diagnoses were reviewed by a specialist within two weeks (67.7%) and were commenced on ART within 91 days (83%), however, there were some concerning delays in those tested at home and in general practice. Partner notification and treatment benefits were discussed with most individuals, unlike the availability of community support and U = U ("undetectable equals untransmittable"). Lengthy delays in ART initiation were mostly due to individuals initially declining ART or missing appointments. Our findings suggest a need for more streamlined pathways into HIV care, review of new diagnoses who have not commenced ART within 8 weeks, and protocol development to ensure discussion of relevant topics. |
