Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK.
Burns, F.M.
Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK. - 2008
NMUH Staff Publications 22
<div class="abstr"><h3><span style="font-size: 8pt;">OBJECTIVE<span style="font-weight: normal;">:</span><span style="font-weight: normal;">To identify </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> for </span><span class="highlight" style="font-weight: normal;">earlier</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;"> within </span><span class="highlight" style="font-weight: normal;">primary</span><span style="font-weight: normal;"> and </span><span class="highlight" style="font-weight: normal;">secondary</span><span style="font-weight: normal;"> care </span><span class="highlight" style="font-weight: normal;">settings</span><span style="font-weight: normal;"> in the </span><span class="highlight" style="font-weight: normal;">UK</span><span style="font-weight: normal;"> in Africans with newly diagnosed </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> infection.</span></span></h3><div><h4><span style="font-size: 8pt;">METHODS:<span style="font-weight: normal;">A survey of newly diagnosed </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;">-positive Africans attending 15 </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> treatment centres across London was conducted between April 2004 and February 2006. The survey consisted of a confidential self-completed questionnaire linked to clinician-completed clinical records.</span></span></h4><h4><span style="font-size: 8pt;">RESULTS:<span style="font-weight: normal;">A total of 263 questionnaires were completed, representing an uptake rate of 79.5% of patients approached and 49.8% (131/263) of participants presented with advanced </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> disease (CD4 cell count < 200 cells/mul at </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;">). In the year prior to </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;"> 76.4% (181/237) had seen their GP, 38.3% (98/256) had attended outpatient services, and 15.2% (39/257) inpatient services, representing </span><span class="highlight" style="font-weight: normal;">missed</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> for </span><span class="highlight" style="font-weight: normal;">earlier</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;">. Of those attending GP services the issue of </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> and/or </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> testing was raised for 17.6% (31/176) and 37.1% (78/210) had a previous negative </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> test, 32.5% of these within the </span><span class="highlight" style="font-weight: normal;">UK</span><span style="font-weight: normal;">. Medical attention was sought for wide ranging reasons, often not obviously connected to underlying </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> status. Despite the population predominantly coming from countries of high </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> prevalence personal appreciation of risk was comparatively low and knowledge of benefits of testing lacking.</span></span></h4><h4><span style="font-size: 8pt;">CONCLUSION:<span style="font-weight: normal;">Africans are accessing health services but clinicians are failing to use these </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> effectively for preventive and diagnostic purposes with regards to </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> infection. Comparatively low appreciation of personal risk and lack of perceived ill health within this community means clinicians need to be more proactive in addressing </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;">.</span></span></h4></div></div>
02699370
Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK. - 2008
NMUH Staff Publications 22
<div class="abstr"><h3><span style="font-size: 8pt;">OBJECTIVE<span style="font-weight: normal;">:</span><span style="font-weight: normal;">To identify </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> for </span><span class="highlight" style="font-weight: normal;">earlier</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;"> within </span><span class="highlight" style="font-weight: normal;">primary</span><span style="font-weight: normal;"> and </span><span class="highlight" style="font-weight: normal;">secondary</span><span style="font-weight: normal;"> care </span><span class="highlight" style="font-weight: normal;">settings</span><span style="font-weight: normal;"> in the </span><span class="highlight" style="font-weight: normal;">UK</span><span style="font-weight: normal;"> in Africans with newly diagnosed </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> infection.</span></span></h3><div><h4><span style="font-size: 8pt;">METHODS:<span style="font-weight: normal;">A survey of newly diagnosed </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;">-positive Africans attending 15 </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> treatment centres across London was conducted between April 2004 and February 2006. The survey consisted of a confidential self-completed questionnaire linked to clinician-completed clinical records.</span></span></h4><h4><span style="font-size: 8pt;">RESULTS:<span style="font-weight: normal;">A total of 263 questionnaires were completed, representing an uptake rate of 79.5% of patients approached and 49.8% (131/263) of participants presented with advanced </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> disease (CD4 cell count < 200 cells/mul at </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;">). In the year prior to </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;"> 76.4% (181/237) had seen their GP, 38.3% (98/256) had attended outpatient services, and 15.2% (39/257) inpatient services, representing </span><span class="highlight" style="font-weight: normal;">missed</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> for </span><span class="highlight" style="font-weight: normal;">earlier</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> </span><span class="highlight" style="font-weight: normal;">diagnosis</span><span style="font-weight: normal;">. Of those attending GP services the issue of </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> and/or </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> testing was raised for 17.6% (31/176) and 37.1% (78/210) had a previous negative </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> test, 32.5% of these within the </span><span class="highlight" style="font-weight: normal;">UK</span><span style="font-weight: normal;">. Medical attention was sought for wide ranging reasons, often not obviously connected to underlying </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> status. Despite the population predominantly coming from countries of high </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> prevalence personal appreciation of risk was comparatively low and knowledge of benefits of testing lacking.</span></span></h4><h4><span style="font-size: 8pt;">CONCLUSION:<span style="font-weight: normal;">Africans are accessing health services but clinicians are failing to use these </span><span class="highlight" style="font-weight: normal;">opportunities</span><span style="font-weight: normal;"> effectively for preventive and diagnostic purposes with regards to </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;"> infection. Comparatively low appreciation of personal risk and lack of perceived ill health within this community means clinicians need to be more proactive in addressing </span><span class="highlight" style="font-weight: normal;">HIV</span><span style="font-weight: normal;">.</span></span></h4></div></div>
02699370