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15th Annual Conference of the British HIV Association1-3 April 2009, Liverpool, UK |
NEWLY DIAGNOSED HIV INFECTION IN AN INNER LONDON GENITO-URINARY MEDICINE (GUM) CLINIC
HIV Med 2009 Apr 1-3 (Suppl 1);15:18 (abstract no. P13)
V Apea1, P Khan1, A De Masi1, M Kall1, T Chadborn2 and I Reeves1
1 Homerton University Hospital, London, UK, 2 Health Protection Agency, London, UK
BACKGROUND: The BHIVA standards for HIV clinical care recommend that all patients with newly diagnosed HIV infection should be assessed within two weeks. This study aimed to assess whether our inner London GUM clinic met these standards.
METHODS: Patients with newly diagnosed HIV infection between 01.01.07 and 31.12.07 were identified. Patient data were obtained from a prospective clinical database and case notes review. Patients diagnosed in our service who then attended elsewhere were identified using the Health Protection Agency’s ‘Survey of Prevalent HIV infections Diagnosed’ (SOPHID) database.
RESULTS: Of 88 patients, 50 (67%) were women, 60 (68%) were of Black African/Caribbean ethnicity. The predominant transmission route was heterosexual (82%). The median age was 40 years. Routine screening in GUM/ante-natal identified 57 patients, 11 tested in primary care and 20 in secondary care. Fifty-eight (66%) patients were of non-B subtype. Advanced disease was common: 21% had an AIDS diagnosis at presentation and 37 (42%) were diagnosed with a CD4 count <200. Overall 93% of our total cohort was seen within 2 weeks but 30 did not attend further follow-up. Of those with CD4 <200, 95% were seen within two weeks but 8 patients did not attend again. Treatment initiation was delayed in two late-presenting patients because of patient reluctance. Seven patients who did not re-attend were confirmed as attending services elsewhere.
CONCLUSIONS: BHIVA standards were met in 93% of our cohort. However, there was significant attrition in attendance for further care, including those with advanced disease. A significant number have not attended other HIV services which may be due to the complex psychosocial difficulties faced by our clinic population. New initiatives are urgently needed to ensure that this complex, at-risk group are fully engaged with HIV services.
2009-04-01
P13
Copyright © 2009 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD