RT Journal Article SR Electronic T1 Who is providing HIV diagnostic testing? Comparing HIV testing by general practitioners and sexual health centres in five regions in the Netherlands, 2011−2018 JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP sextrans-2021-055109 DO 10.1136/sextrans-2021-055109 A1 Saskia J Bogers A1 Denise E Twisk A1 Loes M Beckers A1 Hannelore M Götz A1 Bram Meima A1 Michelle Kroone A1 Elske Hoornenborg A1 Alewijn Ott A1 Marleen N Luning-Koster A1 Nicole H T M Dukers-Muijrers A1 Christian J P A Hoebe A1 Carolina J G Kampman A1 Froukje Bosma A1 Maarten Schim van der Loeff A1 Suzanne Geerlings A1 Jan van Bergen YR 2021 UL http://sti.bmj.com/content/early/2021/07/27/sextrans-2021-055109.abstract AB Objectives General practitioners (GPs) and sexual health centres (SHCs) are the main providers of HIV testing and diagnose two-thirds of HIV infections in the Netherlands. We compared regional HIV testing and positivity by GPs versus SHCs to gain insight into strategies to improve HIV testing, to enable timely detection of HIV infections.Methods Laboratory data (2011–2018) on HIV testing by GPs and SHCs in five Dutch regions with varying levels of urbanisation were evaluated. Regional HIV testing rates per 10 000 residents ≥15 years (mean over period and annual) were compared between providers using negative binomial generalised additive models and additionally stratified by sex and age (15–29 years, 30–44 years, 45–59 years, ≥60 years). χ2 tests were used to compare positivity percentage between the two groups of providers.Results In the study period, 505 167 HIV tests (GP 36%, SHC 64%) were performed. The highest HIV testing rates were observed in highly urbanised regions, with large regional variations. The HIV testing rates ranged from 28 to 178 per 10 000 residents by GPs and from 30 to 378 per 10 000 by SHCs. Testing rates by GPs were lower than by SHCs in three regions and comparable in two. In all regions, men were tested less by GPs than by SHCs; for women, this varied by region. Among those aged 15–29 years old, GPs’ testing rates were lower than SHCs’, while this was reversed in older age categories in four out of five regions. The overall mean HIV positivity was 0.4%. In contrast to other regions, positivity in Amsterdam was significantly higher among individuals tested by GPs than by SHCs.Conclusions This retrospective observational study shows that besides SHCs, who perform opt-out testing for key groups, GPs play a prominent role in HIV testing, especially in non-key populations, such as women and older individuals. Large regional variation exists, requiring region-specific interventions to improve GPs’ HIV testing practices.All data relevant to the study are included in the article or uploaded as supplementary information.