TY - BOOK AU - Burns, F.M. AU - Johnson, A.M. AU - Nazroo, J. AU - Ainsworth, J. AU - Anderson, J. AU - Fakoya, A. AU - Fakoya, I. AU - Hughes, A. AU - Jungmann, E. AU - Sadiq, S.T. AU - Sullivan, A.K. AU - Fenton, K.A. ED - SONHIA Collaboration Group TI - Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK SN - 02699370 PY - 2008/// N1 - NMUH Staff Publications; 22 N2 - <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 &lt; 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> UR - http://www.ncbi.nlm.nih.gov/pubmed/18090399 UR - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00002030-200801020-00014&LSLINK=80&D=ovft ER -