Objectives: Indicator condition-based HIV testing is recommended by the British HIV Association in all clinical settings, including in primary care. We estimated the frequency of non-obstetric HIV testing in primary care in an area of Northeast England with a low prevalence of HIV and examined the effects of clinical and demographic indicators on testing rates.
Methods: We collated data from 358 603 patients across 54 general practices. Multilevel logistic regression modelling was used to identify associations between clinical and demographic indicators and non-obstetric HIV testing.
Results: People with any indicators for testing were more than four times as likely to be tested for HIV than those without (odds ratio [OR] 4.5; 95% confidence interval [CI] 4.10-4.94). Women were less likely than men to have been tested (OR 0.75; 95% CI 0.71-0.80). People aged 56-75 years were less likely to be tested (OR 0.67; 95% CI 0.62-0.72) compared to those aged 16-35; people of white ethnicity were less likely to be tested than those of non-white ethnicity (OR 0.66; 95% CI 0.59-0.73); there was a directional correlation between lower levels of deprivation and reduced likelihood of testing. The overall frequency of testing, however, was low (2.4% in whole study population; 4.9% in people with any indicators for testing).
Conclusion: Low rates of non-HIV testing in primary care, including where clinical and/or demographic indicators are present, represent a barrier to reducing late diagnoses and achieving the UK government's target of eliminating HIV transmission by 2030.
Keywords: HIV; general practice; indicator conditions; primary care; testing.
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