Background The hiv cascade of care includes steps from testing to treatment. Once diagnosed, there are several steps determining the time between testing and linkage to care: Algorithm of hiv tests, communication of test results, way of referral to hiv treatment centre, and confirmation of being in care. In the course of 2010–2015 processes have been changed in the STI clinic to improve linkage to care.

Objectives To evaluate the efficiency of referral to the HIV treatment centres in Rotterdam we investigated the time between date of hiv test, date of referral to and first consultation at the hospital.

Methods We followed newly diagnosed patients from January 2010–March 2015 until linkage to care and collected data on time of HIV testing, discussing diagnosis, referral to and first consultation in care. Median time was calculated between testing, referral and first consultation in care, and regression analysis performed.

Results We identified 227 newly diagnosed patients, of which six refused referral, nine were referred to hospitals outside Rotterdam, and 212 were referred to an hiv-treatment centre in Rotterdam. 41 patients (19%) were lost to follow up, 37 (43%) between 2010 and 2012 vs. 4 (5%) between 2013 and 2015. Of the 171 persons in care, the mean time between hiv test and arrival in hospital was 32 days, and decreased significantly (p = 0.004); median time was 39 days in 2010 and 14 days in 2015. The mean time between testing and referral was 18 days and decreased significantly (p < 0.001); (range median 22 – 9 days). There was no decrease in time between referral and arrival in hospital.

Conclusion Time to entry into care can be improved in cooperation between STI clinic, laboratory and HIV treatment centre. Active follow-up for those referred is needed to facilitate interventions for entry into care.

Disclosure of interest statement No grants were received in the development of this study.