Background Delayed diagnosis of HIV is a problem in both high and low prevalence areas. In Cornwall, the relatively low prevalence means that most general practitioners (GPs) have little or no experience in managing patients with HIV infection; they may be unfamiliar with indicator conditions and thus be unlikely to offer an HIV test.
Aims To see if simple correspondence and feedback regarding testing rates can lead to changes in practice.
Methods We compared testing rates before and after the intervention which comprised of a letter to all individual GPs attached to a PCT weekly communication e-bulletin sent July 2011. This highlighted recent local delayed HIV diagnoses, benefits of earlier testing and contact details of the sexual health clinic. We included an anonymised “ski-jump” graph showing ranked testing rates by practice, an invitation to GPs and practice managers to find out where their practice fell on the graph and the 2008 HIV testing guidelines, drawing attention to the table of indicator conditions.
Results Initial comparison of absolute numbers of tests and tests per head of practice population in GP practices in Cornwall during 2010 revealed large variation in testing rates between practices, from <0.5 tests per 1000 population to approximately 30 tests per 1000 population, with a total of 593 tests over 12 months. An interim analysis of HIV testing rates for the period April to September 2011 has shown an apparent increase in testing of 29% when projected for 12 months. Most practices showed increased rates of testing after the intervention.
Conclusion Our findings suggest that a simple targeted communication may result in increased testing in a low incident GP population. Monthly figures leading up to and following the intervention will be presented.
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