HIV screening in the HIV negative population – A regional HIV clinical network audit of turn-around times and screening offer and uptake 2015

Background:  New BHIVA Standards of care for people living with HIV were published in 2013 on proportion of people newly attending sexual health services with an offer of an HIV test in their clinical records and time between HIV testing being undertaken and results being available and/or shared with the patient. 

Aims:  Baseline regional audit to assess HIV screening offer, uptake and turn-around times within sexual health services to feedback to commissioners. 

Method: Standards set from the ‘Management of Sexually transmitted Infections’ MEDFASH 2014 as BHIVA did not include standard benchmarks.  Retrospective audit of first attendances from period 01/09/14 to 30/11/14. 30 notes for each service were reviewed as coded in each category of HIV testing declined, HIV testing inappropriate and had HIV test. Information collected included documentation of offer, reason given for decline or deemed inappropriate. For those being tested information on time from test to report to patient receiving the result was collected.

Results: 8 services took part. 0.1% HIV positivity rate. 70% overall had documented reason for HIV test decline.  13% were coded as declined with no documented offer.
Percentage of people with needs relating to STI’s who had an HIV test at first attendance 97% offered (achieved in 84%, range 59 to 100%), 80% uptake (achieved in 70%, range 47 to 87%).  3/8 of services met both standards for turn-around times. Overall 92% of services received report from laboratory within 5 working days, range 1 to 20 days (standard 97%) and 90% of patients received their result within 10 working days, range 3 to 30 days (standard 95%).

Discussion: Not all patients appropriate to be tested were offered HIV test, training as to when HIV testing is not appropriate in Sexual health was recommended. Patients in a long term relationship were most likely not to be offered screening, regardless of previous screening history. There was a large variation between processing times in both laboratories and sexual health services. Good practices for those meeting standards were shared with the network.

HIV screening in the HIV negative population – A regional HIV network audit of screening offer, uptake and turn-around times.