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HIV testing within general practices in Europe: a mixed-methods systematic review.

Abstract：

BACKGROUND:Late diagnosis of HIV infection remains a key challenge in Europe. It is acknowledged that general practitioners (GPs) may contribute greatly to early case finding, yet there is evidence that many diagnostic opportunities are being missed. To further promote HIV testing in primary care and to increase the utility of available research, the existing evidence has been synthesised in a systematic review adhering to the PRISMA guidelines. METHODS:The databases PubMed, Scopus and Embase were searched for the period 2006-2017. Two authors judged independently on the eligibility of studies. Through a mixed-methods systematic review of 29 studies, we provide a description of HIV testing in general practices in Europe, including barriers and facilitators. RESULTS:The findings of the study show that although various approaches to target patients are used by GPs, most tests are still carried out based on the patient's request. Several barriers obstruct HIV testing in general practice. Included are a lack of communication skills on sexual health, lack of knowledge about HIV testing recommendations and epidemic specificities, difficulties with using the complete list of clinical HIV indicator diseases and lack of experience in delivering and communicating test results. The findings also suggest that the provision of specific training, practical tools and promotion programmes has an impact on the testing performance of GPs. CONCLUSIONS:GPs could have an increased role in provider-initiated HIV-testing for early case finding. To achieve this objective, solutions to the reported barriers should be identified and testing criteria adapted to primary healthcare defined. Providing guidance and training to better identify priority groups for HIV testing, as well as information on the HIV epidemic's characteristics, will be fundamental to increasing awareness and testing by GPs.

journal_name

BMC Public Health

journal_title

BMC public health

authors

Deblonde J,Van Beckhoven D,Loos J,Boffin N,Sasse A,Nöstlinger C,Supervie V,HERMETIC Study Group.

doi

10.1186/s12889-018-6107-0

subject

Has Abstract

pub_date

2018-10-22 00:00:00

pages

1191

issue

issn

1471-2458

pii

10.1186/s12889-018-6107-0

journal_volume

pub_type

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HIV testing within general practices in Europe: a mixed-methods systematic review.