Reducing Late Diagnosis of HIV in Secondary Care - A Low Prevalence County Approach
PHE ePoster Library. Carroll R. Sep 13, 2016; 138130; 231
Rob Carroll
Rob Carroll
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Abstract
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Abstract Introduction:Late diagnosis of HIV is associated with increased morbidity and mortality. People diagnosed late have a ten-fold increased risk of death within 1 year of diagnosis than those diagnosed promptly. An estimated 1 in 5 people with HIV in the UK are unaware that they have HIV and undiagnosed individuals account for approximately 75% of onward transmission. A project was undertaken in partnership with FY2 doctors to audit late diagnoses in secondary care to identify trends and missed opportunities for earlier diagnosis.Method:An audit of positive HIV tests in two acute hospitals over a 5-year period was completed. Patients were included/excluded based on the following criteria. Included: over 18, new diagnosis of HIV within secondary care, CD4 count <350/AIDS defining illness. Excluded: antenatal testing, sexual health clinic testing, occupational health tests, GP testing. Results:Fourteen patients identified. 12/14 were heterosexual white British males, of which 11 were diagnosed in hospital and mostly admitted under acute medics. Conclusion:A number of changes in practice have occurred. An educational presentation has been developed and delivered to present the results to hospital doctors and a 'Be Clear On HIV' poster has been developed to remind staff of clinical indicators and encourage testing.Microbiology forms have been amended to make it easier for hospital doctors to request HIV tests and there is closer collaboration between hospital physicians, microbiology and HIV consultants. The number of HIV tests in secondary care is also being monitored to identify changes in testing practices.
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