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Uptake of HIV testing in a genitourinary medicine (GUM) clinic setting
A. Joseph, S. Acharya, H. Clemence
Walsall Manor Hospital, Walsall, United Kingdom
Background: Approximately 77,000 HIV positive people are living in United Kingdom of which 28% remain undiagnosed. Of these, 400 HIV positive people die each year. Late diagnosis accounts for 35% of HIV related death.
Methods: A retrospective case notes review was performed in the month of September 2008 in the Department of Genitourinary Medicine, Walsall, UK. Case notes for a total 560 patients over the age of 16 years were reviewed, of whom 252 were males (45%) and 308 (55%) were females. National auditable standards stipulate that 73% of patients attending sexual health clinics should be tested for HIV. However this translates to 27% of patients not being tested. We evaluated the population who declined testing.
Results: Out of the total number of patients, 29% of females and 25% of males were not tested. The largest age group that declined testing was from the 16-25 year age group. Higher proportion of women than men (55/45) declined the test.Reason for declining the test was not documented in the notes of 112 patients. Common reasons that were entered are as follows: window period not being covered in 19, needle phobia in 4, recently tested in 7, one blood donor, one felt that he was at low risk and other reasons in 2 patients.
Conclusions: With the increase mortality in HIV patients who are late presenters HIV testing should have a higher uptake in Genitourinary Medicine clinics than the stipulated current standards. Standard recall system for patients that haven't covered window period and alternative non-invasive tests for patients who fear needles should be considered.
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