The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care

Autor: Maria A. J. de Ridder, Ivo K Joore, Suzanne E. Geerlings, Jan E. A. M. van Bergen, Denise E Twisk, Ann M. Vanrolleghem, Ingrid V F van den Broek
Přispěvatelé: AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, General practice, Infectious diseases, Medical Informatics
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Test strategy
Adult
Male
Sexually Transmitted Diseases
Bacterial
HIV infections/epidemiology
Pediatrics
medicine.medical_specialty
Adolescent
Urban Population
Gonorrhea
General Practice
HIV Infections
Case-control studies
03 medical and health sciences
Young Adult
0302 clinical medicine
Sex Factors
SDG 3 - Good Health and Well-being
Risk Factors
medicine
Electronic Health Records
Humans
HIV infections/prevention & control
030212 general & internal medicine
Syphilis
Young adult
Netherlands
Retrospective Studies
030505 public health
Primary Health Care
business.industry
Incidence (epidemiology)
Medical record
Incidence
Case-control study
Retrospective cohort study
Odds ratio
Middle Aged
medicine.disease
Lymphogranuloma Venereum
Female
0305 other medical science
business
Family Practice
Primary healthcare
Research Article
Zdroj: BMC family practice, 17(1). BioMed Central
BMC Family Practice
BMC Family Practice, 17:161. BioMed Central Ltd.
ISSN: 1471-2296
DOI: 10.1186/s12875-016-0556-2
Popis: Background European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis. Methods We did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis. Results We included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy. Conclusions Our study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs’ future guidelines and that education strategies be used to facilitate its implementation in daily practice. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0556-2) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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