Reassessing HIV Detection Strategies: An Analysis of Opportunistic Screening vs. Indicator-Condition-Driven Diagnosis in Valencia, Spain.

Our study assessed the characteristics of people living with HIV (PLWH) detected via opportunistic screening in Valencia (Spain) to determine diagnoses potentially missed under a more restrictive, indicator-condition diagnostic strategy. We conducted a retrospective analysis of electronic health rec...

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Publicado en:Journal of Community Health Vol. 49; no. 4; pp. 748 - 755
Autores principales: Ortega, Enrique, Ocete, María Dolores, Martínez-Roma, María, Gimeno, Concepción, Gómez, Neus, Diago, Moisés, Carrodeguas, Alba, Medina, Diogo, García-Deltoro, Miguel
Formato: Artículo
Publicado: Springer Nature Aug2024
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Springer Nature
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        10.1007/s10900-024-01326-9
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        atl: Reassessing HIV Detection Strategies: An Analysis of Opportunistic Screening vs. Indicator-Condition-Driven Diagnosis in Valencia, Spain.
      aug:
        au:
          Ortega, Enrique
          Ocete, María Dolores
          Martínez-Roma, María
          Gimeno, Concepción
          Gómez, Neus
          Diago, Moisés
          Carrodeguas, Alba
          Medina, Diogo
          García-Deltoro, Miguel
        affil:
          https://ror.org/02wcq1q49 Fundació Investigació Hospital General Universitari de Valencia, Valencia, Spain
          Consorci Hospital General Universitari de Valencia, Valencia, Spain
          https://ror.org/043nxc105 Facultad de Medicina, Universidad de Valencia, Valencia, Spain
          https://ror.org/02qacef07 Gilead Sciences, Madrid, Spain
      su:
        Spain
        Medical care
        Nomads
        Retrospective studies
        Medical screening
        Diagnosis of HIV infections
        HIV prevention
        Research funding
        HIV-positive persons
        CD4 lymphocyte count
        Spaniards
        Medical records
        Acquisition of data
        Electronic health records
        AIDS serodiagnosis
        Medical appointments
        Early diagnosis
        Delayed diagnosis
        Time
      sug:
        subj:
          Medical care
          Nomads
          Retrospective studies
          Medical screening
          Spain
          All Other Miscellaneous Ambulatory Health Care Services
          Diagnosis of HIV infections
          HIV prevention
          Research funding
          HIV-positive persons
          CD4 lymphocyte count
          Spaniards
          Medical records
          Acquisition of data
          Electronic health records
          AIDS serodiagnosis
          Medical appointments
          Early diagnosis
          Delayed diagnosis
          Time
      keyword:
        Diagnosis Strategy
        HIV
        Linkage to care
        Screening
        Diagnosis Strategy
        HIV
        Linkage to care
        Screening
      ab: Our study assessed the characteristics of people living with HIV (PLWH) detected via opportunistic screening in Valencia (Spain) to determine diagnoses potentially missed under a more restrictive, indicator-condition diagnostic strategy. We conducted a retrospective analysis of electronic health records of 97 PLWH diagnosed between April 2019 and August 2022. The main outcomes reported were patient CD4 T cell count, known HIV risk factors at diagnosis, and missed opportunities for diagnosis, defined as the failure of a previously untested patient to undergo HIV testing despite attending previous visits to healthcare facilities prior to diagnosis. Successful linkage to care was achieved for 95.9% of diagnosed patients. Half of the PLWH were diagnosed late, while 47.8% did not meet the criteria for indicator-condition-driven HIV diagnosis at the time of their diagnosis. Additionally, 52.2% did not receive HIV testing despite an average of 5.1 ± 6.0 healthcare visits in the 12 months prior to diagnosis. Spaniards had more missed opportunities for diagnosis than foreigners (64% vs. 40%, p = 0.02). Depending solely on an indicator-condition-driven HIV diagnosis approach could result in 47.8% of cases being missed. Including "migrants" as a testing criterion could lower missed diagnoses to 25.3% but might create inequities in prevention access. In conclusion, our findings provide valuable insights to enhance HIV testing, early diagnosis, and linkage to care. While it is crucial to uphold the indicator-condition-driven HIV diagnosis as baseline practice, improving screening strategies will decrease late diagnoses and missed opportunities, thereby effectively contributing to end the epidemic.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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