P093 HIV testing for hospital inpatients in a priority area

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Abstract

Introduction

Department of Health advises that HIV testing should be routinely offered to patients in priority areas; where prevalence ≥1–2/1000, such as Brighton. We sought to increase HIV testing in the Cardiology department. Local microbiology department advises HIV testing on all inpatients with suspected or proven infective endocarditis (IE), as such we investigated testing in this group.

Aim

Assess the proportion of patients with suspected or proven IE offered a HIV test at baseline, and following an intervention to promote testing.

Methods

Patients with IE are discussed at a weekly multi-disciplinary team (MDT). We retrospectively reviewed MDT meetings from June – November 2016 (cycle one). Data on HIV testing were extracted from MDT proforma and hospital results system. Initial results were presented to cardiology junior doctors and testing encouraged. We prospectively reviewed MDT meetings and HIV testing in the 10 weeks after the intervention (cycle two).

Results

In cycle one, 29 patients (25 males, 4 females) had suspected or proven IE, 16 (55%) were tested. In cycle two the proportion of patients tested for HIV decreased; of the 8 patients with suspected/proven IE (6 males, 2 females); 2 (25%) were tested, 6 (75%) were not.

Discussion

HIV testing rate decreased by 46% between cycles, representing multiple missed opportunities for testing. The reason for this trend is not clear but barriers to HIV testing remain, including poor awareness of indications to test, uncertainty around consent, and assumption of low risk. We plan further interventions to increase HIV testing locally.

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