Background Delayed diagnosis of HIV is associated with significantly increased morbidity and mortality. Our clinic has a high rate of advanced HIV at diagnosis (61% presenting with a CD4 <350) indicating that there may be missed opportunities for earlier testing.

Aim To review all recent new diagnoses of HIV for potential missed testing opportunities.

Methods Retrospective review of clinic, hospital and emergency department records for all new patients referred to the HIV clinic between January 2014 and January 2015. Previous hospital admissions, outpatient and emergency department attendances and GP visits were reviewed for the year up to diagnosis. Where a patient was admitted to hospital, time to diagnosis, outcome and inpatient stay was recorded.

Results 70 new patients: 24 transfers of care (excluded); 46 new diagnoses.

24/46 (52%) were seen at least once at the hospital or by the GP in the 12 months prior to their diagnosis. 14 admissions to hospital at the time of diagnosis: mean length of stay 14 days (range 2–47).

Discussion There are significant opportunities for earlier HIV testing in our hospital and local GP practices. We are using this data as part of a business case to roll out HIV testing for all acute medical admissions.