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HIV—testing, new diagnoses, management and PEPSE
P5 Changing trends in HIV diagnosis in an inner city London teaching hospital between 2007 and 2011
  1. H Wilkin-Crowe1,
  2. R Lau2,
  3. M Pakianathan2
  1. 1St. George's Medical School, London, UK
  2. 2St. George's Healthcare NHS Trust, London, UK

Abstract

Background In 2008, guidelines were published by the British Association for Sexual Health and HIV, British HIV Association and British Infection Society recommending normalisation of HIV testing to reduce stigma and to increase the number of early diagnoses. The guidelines aimed at reducing morbidity, mortality and reducing the risk of onward transmission of HIV. Local initiatives were carried out in South West London to achieve this by extensive general practice education programmes to raise HIV testing awareness in non-sexual health (SH) settings.

Aims To establish the effect of a number of local initiatives to promote HIV testing in non-SH settings at a large South West London hospital.

Methods Data on all new diagnoses referred to the HIV outpatient were collected and analysed from electronic patient records, including ethnodemographic data, place of diagnosis and clinical data including baseline CD4 count. Previously diagnosed patients having received HIV care elsewhere transferring into the service were excluded. Fisher's exact t-test was used for statistical analysis.

Results and discussion There were 394 patients with a new diagnosis of HIV between 2007 and 2011. Diagnosis by primary care and other non-SH settings increased by 184%. There was an increase of 37% in the median CD4 count at diagnosis, taking the median count to 372 cells/mm3 in 2011, showing the majority of patients to have been diagnosed at an early stage. The proportion of very late presenters decreased by 24%.

Conclusions The evidence suggests that local initiatives are successfully implementing National guidelines. More work is needed to increase HIV testing and reduce the number of late diagnoses.

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