Evidence map›Paper›PMID 39731054›Full record

Observational studyBMC primary care2024

Implementing HIV teams to improve HIV indicator condition-guided testing in general practitioner centers in the Netherlands.

Carlijn C E Jordans, Lotte Niemantsverdriet-Rokx, Jan L Struik, Eva C van der Waal, Paul V J M van der Voorn, Nienke Bakker, Annelies Verbon, Patrick J E Bindels, Casper Rokx

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05225493 (Supporting Health Care Professionals in Hospital and Primary Care to Promote Adequate HIV Risk and Indicator Condition Driven Testing in Routine Care.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05225493 unknown statusnot on this map

Supporting Health Care Professionals in Hospital and Primary Care to Promote Adequate HIV Risk and Indicator Condition Driven Testing in Routine Care.

TypeobservationalSponsorErasmus Medical CenterRan2020 to 2024Enrolled1,500ConditionsHIV Infections, Primary Health Care, Acquired Immunodeficiency Syndrome, Sexually Transmitted Diseases, ViralArmsPeer to peer feedback, HIV rapid test
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Carlijn C E JordansDepartment of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3015 CN, The Netherlands. c.jordans@erasmusmc.nl.
Lotte Niemantsverdriet-RokxGezondheidscentrum Mathenesserlaan, Rotterdam, The Netherlands.
Jan L StruikGezondheidscentrum Mathenesserlaan, Rotterdam, The Netherlands.
Eva C van der WaalHuisartsenpraktijk Händellaan, Delft, The Netherlands.
Paul V J M van der VoornHuisartsenpraktijk Händellaan, Delft, The Netherlands.
Nienke BakkerHuisartsenpraktijk Rozenburcht, Capelle aan den Ijssel, The Netherlands.
Annelies VerbonDepartment of Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
Patrick J E BindelsDepartment of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.
Casper RokxDepartment of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3015 CN, The Netherlands.

Funding

AIDSfonds p-61803Dutch Federation Medical Specialist (SKMS) 59825882
6 · The paper itself

Abstract

backgroundHIV indicator condition-guided testing is recommended by guidelines to identify undiagnosed HIV infections. However, general practitioners (GPs) frequently see patients for indicator conditions without testing them for HIV. The aim of this study was to evaluate whether implementing HIV teams, using trained GP ambassadors, promoted local HIV indicator condition-guided testing practices in urban GP centers in the Netherlands.

methodsWe conducted a prospective implementation study between May 2021 and March 2023. Patients ≥ 18 years newly diagnosed with HIV indicator conditions in three GP centers were included. The intervention consisted of HIV expert led education for GPs with a stepwise implementation of point-of-care testing (phase 1), followed by adding peer-to-peer case feedback by trained GP ambassadors (phase 2). Questionnaires were used to assess the experiences and beliefs of HIV indicator condition-driven testing in patients and GPs. The primary outcome was the overall HIV testing rate in patients diagnosed with indicator conditions compared to pre-implementation. Secondary outcomes were HIV testing rate per phase and per indicator condition, HIV positivity rate, and patients' and GPs' experiences with this testing strategy.

resultsIn 132,338 patient visits, 846 (0.6%, 95%CI 0.6-0.7%) HIV indicator conditions were diagnosed, including 485 sexually transmitted infections (57.3%). Overall, 215 (25.4%) indicator conditions were tested for HIV after the implementation of HIV teams. The testing rate was comparable between the two phases (25.2% versus 25.9%, p = 0.83). The testing rates pre- and post-implementation were comparable (21.3% versus 25.4%, p = 0.33). The most frequently tested HIV indicator conditions were unexplained weight loss (n = 13, 41.9%), unexplained lymphadenopathy (n = 8, 38.1%), and sexually transmitted infections (n = 161, 33.2%). Three patients (1.4%, 95%CI 0.3-4.0%) tested positive for HIV. Test acceptance in patients was high as was the self-perceived knowledge of GPs on HIV indicator conditions.

conclusionsImplementing HIV teams did not enhance HIV indicator condition-guided testing in urban GP centers from a low HIV prevalence setting. The high patients acceptance rate and self-perceived knowledge among GPs regarding HIV indicator conditions did not manifest in high HIV testing rates. Patients accepted testing, but a gap was found between the self-perceived knowledge of GPs regarding HIV indicator conditions and testing, and the actual HIV testing rate.

trial registrationClinicalTrials.gov NCT05225493 (registration date: 17-01-2022).

Indexed as

HIV InfectionsAdultFemaleGeneral PractitionersHIV TestingHumansMaleMass ScreeningMiddle AgedNetherlandsPoint-of-Care TestingProspective StudiesYoung AdultAIDSFamily careGeneral practitionerHIVHIV testingIndicator conditionPrimary care

Identifiers

PMID39731054
PMCPMC11681718

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.