Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK.
Publication details: 2008ISSN:- 02699370
- AIDS
Item type | Home library | Collection | Class number | Status | Date due | Barcode | |
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Book | Ferriman information and Library Service (North Middlesex) Shelves | Staff publications for NMDX | Available |
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 &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>
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