12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

COULD PRIMARY CARE BE DOING MORE?

HIV Med 2006; 7(Suppl. 1):8 (abstract no. O29)

Fiona Burns¹, Anne Johnson¹, James Nazroo², Ibidun Fakoya¹, Jane Anderson³, Munyaradzi Chikohora⁴, Simone Ghosh⁵, Andy Hughes⁶, Eva Jungmann⁷, Sarah Manney⁸, Nneka Nwokolo⁹, Nina Panahmand⁷, Michelle Slinn¹⁰, Richard Stack⁹, Ann K. Sullivan⁹, Cheryl Tawana¹¹, Fiona Young¹² and Kevin Fenton^13
1 Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, ² Department of Epidemiology and Public Health, UCL, London, ³ Homerton University Hospital NHS Trust, London, ⁴ North West London Hospitals NHS Trust, London, ⁵ St Georges Healthcare NHS Trust, London, ⁶ St Mary’s NHS Trust, London, ⁷ Camden Primary Care Trust, London, ⁸ Barts and The London NHS Trust, London, ⁹ Chelsea and Westminster Healthcare NHS Trust, London, ¹⁰ West Hertfordshire Hospitals NHS Trust, Watford, ¹¹ Newham University Hospital NHS Trust, London, ¹² North Middlesex University Hospital NHS Trust, London, UK, ¹³ Centre for Disease Control, Atlanta, GA, USA

INTRODUCTION: In the UK, Africans present to HIV services with significantly more advanced HIV disease than non-Africans, denying themselves the full benefit of available treatment. Little is known about healthcare utilisation prior to diagnosis for this population.

OBJECTIVES: To identify opportunities for earlier diagnosis of HIV amongst Africans in London.

METHODS: A survey of newly diagnosed HIV-positive Africans attending 14 HIV treatment centres across London between April 2004 and February 2006 using a self-completed questionnaire linked to clinical records.

RESULTS: 236 questionnaires were completed, representing an 82% response rate. 66% of respondents were women, 72.3% came from countries with an HIV prevalence of over 15%, 78.3% were aged between 25 and 44, and 54.2% had advanced HIV (CD4 <200 cells/µl or an AIDS-defining illness) at the time of diagnosis. 84.7% of respondents were registered with a GP for a medium time of 3 years, and 75% saw their GP within the 2 years prior to diagnosis, most commonly for flu or chest infection. In the year prior to diagnosis 69.3% saw their GP for a medium of two visits (range 1–18). HIV testing was raised by the GP for 16.3% of participants.

DISCUSSION: These preliminary data show that primary care services are well accessed by this population. The demography alone should alert clinicians to considering HIV irrespective of health status. However, for over 80% of respondents who attended their GP, the issue of HIV testing was not broached. Work with primary care services is required to understand and overcome the barriers to discussing HIV infection for this, and all, populations.

2006-03-29
O29

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