Training nurses in general practitioners’ offices to routinely offer HIV testing to patients is associated with a boost in testing rates and earlier diagnosis.
Researchers from Queen Mary University and University College London conducted a study of 42 general health practices in London. They published their findings in EClinicalMedicine.
Nineteen of the practices were randomized to receive the “trial intervention,” including a training session for nurses on routine testing, a follow-up meeting, routine support from the research team and integration of a system of prompts to nurses to offer routine testing to patients. Thirteen of the practices received the “implementation intervention,” which included a single training for staff on providing routine HIV testing. These practices were compared with 10 practices that received neither intervention.
A previous paper reported the trial intervention outcomes, showing that the approach increased both the number of HIV tests and the number of diagnoses.
In the implementation intervention practices, the testing rate increased by 85%, and the HIV diagnosis rate by 34%. The average CD4 count at diagnosis increased by 55% (from 273 to 425), meaning HIV was being diagnosed much earlier in the course of infection. Compared with the practices that did not receive an intervention, the implementation intervention practices had diagnosis rates that were 106% higher and a 35% higher CD4 count at diagnosis.
Testing and diagnosis rates and average CD4 counts were similar in the trial intervention practices and the implementation intervention practices, showing that the simpler implementation intervention, intended for widespread use, worked as well as the more intensive trial intervention.
Most of the new diagnoses were among people who have the highest rates of late HIV diagnosis, including heterosexuals, Black Africans and Black people from the Caribbean.
“During our initial research study, we found that offering HIV tests to new patients did pick up previously undiagnosed cases of HIV,” study co-lead Werner Leber, MD, a general practitioner (GP) and clinical lecturer in primary care at Queen Mary University of London, said in a press release. “The data collected outside the clinical trial environment and published today shows that the intervention is effective in routine care within modern GP practices.”
To read a press release about the study, click here.
To read the study abstract, click here.