Late HIV diagnosis is an important determinant of morbidity and mortality. An audit of new HIV diagnoses in our service based an area of high prevalence, showed high rates of late diagnosis in 2012, so an HIV education programme was implemented within the Trust. We re-audited new diagnoses in 2015 to look at the impact of the programme and compared the results.Methods
A retrospective case-note review of all newly diagnosed patients seen in our HIV clinic from 1st January 2015 – 31st December 2015.Results
53 patients were identified in comparison to 56 in 2012, of which 64% were male compared with 55% in 2012. Median age was 41.5 years (range 21 – 68) compared with 39.5 years (range 20 – 64) in 2012. 53% were diagnosed with a CD4 count <350 cells/mm3 compared with 63% in 2012 and 34% had a CD4 count <200 cells/mm3 compared with 45% <200cells/mm3 in 2012. 51% had been seen in the preceding year by doctor, compared with 52% in 2012. 49% were diagnosed in a sexual health service compared with 39% in 2012.Discussion
Our re-audit showed continued high rates of late diagnosis despite a dedicated educational programme. This suggests that education alone is not sufficient to cause a sustained impact on late diagnosis rates. HIV testing needs to be embedded in routine clinical care, such as opt out testing as advised in UK national testing guidelines, or by using pathology system alerts to suggest testing if blood results are indicative.