AEGiS-11IAC: HIV-testing on the initiative of the patient in general practice in eight European countries (1990-1994) ("Europe against AIDS")

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

HIV-testing on the initiative of the patient in general practice in eight European countries (1990-1994) ("Europe against AIDS")

Int Conf AIDS 1996 Jul 7-12; 11:33 (abstract no. LB.C.6058)
Van Renterghem H, Van Casteren V, Szecsenyi J, Bartelds A, Cloetta J, Falcao I, Massari V, Maurice S, Vega AT, Wigersma L, Stroobant A; Institute for Hygiene and Epidemiology, Brussels, Belgium. Fax: 32-2-642-5410. E-mail: andre.stroobant@epinov.ihe.be.

OBJECTIVE: To describe and explain regional/national differences and temporal changes in the demand for HIV-test by patients in general practice in eight European countries.

METHODS: From 1990 to 1994, 9 sentinel networks (SNs) of general practitioners (GPs) from 7 European countries--Belgium (national SN), France (national SN RNTMT; regional SN Aquitaine), the Netherlands (national SN NIVEL; regional SN Amsterdam, 1994 only), Portugal (national SN Medicos Sentinella, 1994 only), Spain (regional SN Castilla y Leon), Germany (regional SN Kassel), Switzerland (national SN Sentinella)--participated in the study, covering approximately 4000 GP-working years. The GPs registered on a weekly basis all HIV-test prescriptions in their practice. Variables recorded: initiator of the HIV-test, patients' age, sex, risk group, reason for testing and previous HIV-tests.

RESULTS: Data concerning 36467 HIV-test prescriptions were collected. The proportion of tests on the initiative of the patient ranged from 35% (Portugal-1994; Spain-1992) to 93% (the Netherlands-1994). The number of tests on the initiative of the patient increased considerably both proportionately and absolutely in all networks between 1990 and 1994. At the same time the number of HIV-tests on the initiative of the GP decreased. In most networks an important and steadily increasing proportion of the patients had been tested on HIV before, this due to a cumulative effect, most explicitly in Belgium (28.6% in 1994) and in Switzerland (27.3% in 1994), lowest in the Netherlands (12.7% in 1994). Depending upon the network between 35% (France 1990) and 85% (the Netherlands 1990-94) of the HIV-tests on initiative of the patient concerned patients at risk. This figure increased in all networks both in absolute and proportionate figures between 1990 and 1994. For patients considered at risk, heterosexuals with risk behavior were most frequent, ranging between 20% (France) and 50% (the Netherlands) of all HIV-tests on the initiative of the patient, except for Spain and Germany-1993 where respectively injecting drug use and blood transfusion were the most common risk factors.

CONCLUSION: This study illustrates that HIV-testing in general practice in large parts of Europe is to an increasing extent happening as a result of a more active HIV-test seeking behavior by the patients and this especially by patients at risk. This reflects a still growing awareness concerning the possibility of being infected with HIV in the general population and among those at risk.

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