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Trends in HIV testing in the UK primary care setting: A 15-year retrospective cohort study from 2000 to 2015

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Trends in HIV testing in the UK primary care setting : A 15-year retrospective cohort study from 2000 to 2015. / Gompels, Mark; Michael, Skevi; Davies, Charlotte; Jones, Tim; MacLeod, John; May, Margaret.

In: BMJ Open, Vol. 9, No. 11, e027744, 24.11.2019.

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@article{4500e893449941fe8cc799482c3b6159,
title = "Trends in HIV testing in the UK primary care setting: A 15-year retrospective cohort study from 2000 to 2015",
abstract = "ObjectivesTo estimate trends in HIV testing, positivity and prevalence in UK Primary Care for 2000-2015 as part of a wider investigation into reasons for late diagnosis of HIV. DesignRetrospective cohort study using the Clinical Practice Research Datalink (CPRD) which is derived from computerised clinical records produced during consultations in Primary Care.Setting: 404 General Practices in England. Participants 5,979,598 adults aged ≥ 16 years registered between 2000-2015 with 45,093,761 person years of observation.OutcomesAnnual HIV testing rates, proportion of positive tests, and prevalence of HIV-infected people recorded in Primary Care 2000-2015.ResultsHIV testing in Primary Care increased from 2000 to 2010, but then declined. Testing was higher in females than males and in those aged 16-44 years compared with older adults. Rates per 100,000 in women aged 16-44 years were 177 (95{\%} CI 167-188); 1309 (1282-1336); 1789 (1757-1821) and 839 (817-862) in 2000, 2005, 2010 and 2015, respectively, and for non-pregnant women: 22.5 (19-26); 134 (125-143); 262 (250-275); 190 (179, 201). For men aged 16-44 years rates were: 26 (22-29); 107 (100-115); 196 (185-206); 137 (127-146). Over the study period, there were approximately 2 positive results per 1000 HIV tests. Men were eight-fold more likely to test positive than women. The percentage of HIV diagnoses among adults recorded in CPRD may be as low as 55{\%} in London and 67{\%} in the rest of the UK.ConclusionsHIV testing rates in Primary Care peaked in 2010 and subsequently declined. Access to testing was higher for women despite the prevalence of HIV being higher in men.Implications and further research neededOpportunities remain in Primary Care for increasing HIV testing to prevent costly late diagnoses and decrease HIV transmission. Interventions to improve targeting of tests and increase adherence to HIV testing guidelines are needed in Primary Care.",
keywords = "CPRD, HIV & AIDS, HIV testing, primary care",
author = "Mark Gompels and Skevi Michael and Charlotte Davies and Tim Jones and John MacLeod and Margaret May",
year = "2019",
month = "11",
day = "24",
doi = "10.1136/bmjopen-2018-027744",
language = "English",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "11",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Trends in HIV testing in the UK primary care setting

T2 - A 15-year retrospective cohort study from 2000 to 2015

AU - Gompels, Mark

AU - Michael, Skevi

AU - Davies, Charlotte

AU - Jones, Tim

AU - MacLeod, John

AU - May, Margaret

PY - 2019/11/24

Y1 - 2019/11/24

N2 - ObjectivesTo estimate trends in HIV testing, positivity and prevalence in UK Primary Care for 2000-2015 as part of a wider investigation into reasons for late diagnosis of HIV. DesignRetrospective cohort study using the Clinical Practice Research Datalink (CPRD) which is derived from computerised clinical records produced during consultations in Primary Care.Setting: 404 General Practices in England. Participants 5,979,598 adults aged ≥ 16 years registered between 2000-2015 with 45,093,761 person years of observation.OutcomesAnnual HIV testing rates, proportion of positive tests, and prevalence of HIV-infected people recorded in Primary Care 2000-2015.ResultsHIV testing in Primary Care increased from 2000 to 2010, but then declined. Testing was higher in females than males and in those aged 16-44 years compared with older adults. Rates per 100,000 in women aged 16-44 years were 177 (95% CI 167-188); 1309 (1282-1336); 1789 (1757-1821) and 839 (817-862) in 2000, 2005, 2010 and 2015, respectively, and for non-pregnant women: 22.5 (19-26); 134 (125-143); 262 (250-275); 190 (179, 201). For men aged 16-44 years rates were: 26 (22-29); 107 (100-115); 196 (185-206); 137 (127-146). Over the study period, there were approximately 2 positive results per 1000 HIV tests. Men were eight-fold more likely to test positive than women. The percentage of HIV diagnoses among adults recorded in CPRD may be as low as 55% in London and 67% in the rest of the UK.ConclusionsHIV testing rates in Primary Care peaked in 2010 and subsequently declined. Access to testing was higher for women despite the prevalence of HIV being higher in men.Implications and further research neededOpportunities remain in Primary Care for increasing HIV testing to prevent costly late diagnoses and decrease HIV transmission. Interventions to improve targeting of tests and increase adherence to HIV testing guidelines are needed in Primary Care.

AB - ObjectivesTo estimate trends in HIV testing, positivity and prevalence in UK Primary Care for 2000-2015 as part of a wider investigation into reasons for late diagnosis of HIV. DesignRetrospective cohort study using the Clinical Practice Research Datalink (CPRD) which is derived from computerised clinical records produced during consultations in Primary Care.Setting: 404 General Practices in England. Participants 5,979,598 adults aged ≥ 16 years registered between 2000-2015 with 45,093,761 person years of observation.OutcomesAnnual HIV testing rates, proportion of positive tests, and prevalence of HIV-infected people recorded in Primary Care 2000-2015.ResultsHIV testing in Primary Care increased from 2000 to 2010, but then declined. Testing was higher in females than males and in those aged 16-44 years compared with older adults. Rates per 100,000 in women aged 16-44 years were 177 (95% CI 167-188); 1309 (1282-1336); 1789 (1757-1821) and 839 (817-862) in 2000, 2005, 2010 and 2015, respectively, and for non-pregnant women: 22.5 (19-26); 134 (125-143); 262 (250-275); 190 (179, 201). For men aged 16-44 years rates were: 26 (22-29); 107 (100-115); 196 (185-206); 137 (127-146). Over the study period, there were approximately 2 positive results per 1000 HIV tests. Men were eight-fold more likely to test positive than women. The percentage of HIV diagnoses among adults recorded in CPRD may be as low as 55% in London and 67% in the rest of the UK.ConclusionsHIV testing rates in Primary Care peaked in 2010 and subsequently declined. Access to testing was higher for women despite the prevalence of HIV being higher in men.Implications and further research neededOpportunities remain in Primary Care for increasing HIV testing to prevent costly late diagnoses and decrease HIV transmission. Interventions to improve targeting of tests and increase adherence to HIV testing guidelines are needed in Primary Care.

KW - CPRD

KW - HIV & AIDS

KW - HIV testing

KW - primary care

UR - http://www.scopus.com/inward/record.url?scp=85075564044&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2018-027744

DO - 10.1136/bmjopen-2018-027744

M3 - Article

C2 - 31767577

AN - SCOPUS:85075564044

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 11

M1 - e027744

ER -