Abstract

Objectives: To provide nationally representative data on trends in HIV testing in primary care, and to estimate the proportion of diagnosed HIV positive individuals known to general practitioners (GPs).

Methods: We undertook a retrospective cohort study between 1995-2005 of all general practices contributing data to the United Kingdom General Practice Research Database (GPRD), and data on persons accessing HIV care (Survey of Prevalent HIV Infections Diagnosed). We identified all practice-registered patients where an HIV test or HIV positive status is recorded in their general practice records. HIV testing in primary care, and prevalence of recorded HIV positive status in primary care were estimated.

Results: Despite 11-fold increases in male testing, and 19-fold increases in non-pregnant female testing between 1995 and 2005, HIV testing rates remained low in 2005 at 71.3 and 61.2 tests per 100,000 person years for males and females respectively, peaking at 162.5 and 173.8 per 100,000 person years at 25-34 years of age. Inclusion of antenatal tests yielded a 129 fold increase in women over the 10 year period. In 2005, 50.7% of HIV positive individuals had their diagnosis recorded, with a lower proportion in London (41.8%) than outside the capital (60.1%).

Conclusion: HIV testing rates in primary care remain low. Normalisation of HIV testing and recording in primary care in antenatal testing has not been accompanied by a step change in wider HIV testing practice. Recording of HIV positive status by general practitioners (GPs) remains low, and GPs may be unaware of HIV-related morbidity or potential drug interactions.