Carlijn C E Jordans, Klaske Vliegenthart-Jongbloed, Kara K Osbak, Jaap L J Hanssen, Jan van Beek, Marion Vriesde, Natasja van Holten, Willemien Dorama, Dorien van der Sluis, Jurriaan de Steenwinkel, Jeroen van Kampen, Annelies Verbon, Anna H E Roukens, Casper Rokx
{"title":"Implementing HIV teams sustainably improves HIV indicator condition testing rates in hospitals in the Netherlands: the #aware.hiv clinical trial.","authors":"Carlijn C E Jordans, Klaske Vliegenthart-Jongbloed, Kara K Osbak, Jaap L J Hanssen, Jan van Beek, Marion Vriesde, Natasja van Holten, Willemien Dorama, Dorien van der Sluis, Jurriaan de Steenwinkel, Jeroen van Kampen, Annelies Verbon, Anna H E Roukens, Casper Rokx","doi":"10.1097/QAD.0000000000004167","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Develop and validate a strategy to improve HIV testing rates using HIV teams.</p><p><strong>Design: </strong>A prospective clinical trial was conducted from January 2020 to July 2023 in two Dutch university hospitals.</p><p><strong>Methods: </strong>The intervention involved implementing HIV teams to provide peer awareness, education, and feedback to physicians treating patients ≥18 years newly diagnosed with HIV indicator conditions. The primary outcome was the HIV testing rate. Secondary outcomes included testing rates by specialty, HIV prevalence, and reasons for withholding testing.</p><p><strong>Results: </strong>Of the 313,666 newly registered diagnoses, 2,395 involved indicator conditions. The overall HIV testing rate of newly diagnosed HIV indicator conditions increased from 50.1% (222/443) pre-implementation to 80.7% (1,575/1,952) post-implementation of HIV teams (p < 0.001) with sustained improvement during the observation period (range 72.4-90.4%). The intervention was effective across physicians from all medical specialties. HIV prevalence among those tested was 0.6% (95%CI 0.3-1.1%). Peer feedback for 411 untested indicator conditions, resulted in 69 (16.3%) additional HIV tests. Failure to test frequently remained without reason (50.6%) or due to patient loss of follow-up (18.4%). Multivariate analysis indicated that women with indicator conditions were tested less often (aOR 0.59, 95%CI 0.45-0.79, p < 0.01), and indicator conditions without HIV testing recommendations in national guidelines were also less likely to be tested for HIV (aOR 0.36, 95%CI 0.27-0.48, p < 0.01). For external validation, we implemented this intervention in a second hospital, where it also significantly increased the testing rate post-implementation of HIV teams.</p><p><strong>Conclusion: </strong>Implementing HIV teams in hospitals is feasible, effective and leads to a sustained increase in HIV indicator condition-guided testing, supporting its broader adoption.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004167","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Develop and validate a strategy to improve HIV testing rates using HIV teams.
Design: A prospective clinical trial was conducted from January 2020 to July 2023 in two Dutch university hospitals.
Methods: The intervention involved implementing HIV teams to provide peer awareness, education, and feedback to physicians treating patients ≥18 years newly diagnosed with HIV indicator conditions. The primary outcome was the HIV testing rate. Secondary outcomes included testing rates by specialty, HIV prevalence, and reasons for withholding testing.
Results: Of the 313,666 newly registered diagnoses, 2,395 involved indicator conditions. The overall HIV testing rate of newly diagnosed HIV indicator conditions increased from 50.1% (222/443) pre-implementation to 80.7% (1,575/1,952) post-implementation of HIV teams (p < 0.001) with sustained improvement during the observation period (range 72.4-90.4%). The intervention was effective across physicians from all medical specialties. HIV prevalence among those tested was 0.6% (95%CI 0.3-1.1%). Peer feedback for 411 untested indicator conditions, resulted in 69 (16.3%) additional HIV tests. Failure to test frequently remained without reason (50.6%) or due to patient loss of follow-up (18.4%). Multivariate analysis indicated that women with indicator conditions were tested less often (aOR 0.59, 95%CI 0.45-0.79, p < 0.01), and indicator conditions without HIV testing recommendations in national guidelines were also less likely to be tested for HIV (aOR 0.36, 95%CI 0.27-0.48, p < 0.01). For external validation, we implemented this intervention in a second hospital, where it also significantly increased the testing rate post-implementation of HIV teams.
Conclusion: Implementing HIV teams in hospitals is feasible, effective and leads to a sustained increase in HIV indicator condition-guided testing, supporting its broader adoption.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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