@article{mbs:/content/journal/acmi/10.1099/acmi.fis2019.po0013, author = "Bulteel, Naomi and Bularga, Anda and Baker, Kerri and Sloan, Derek and Banerjee, Indranil", title = "A decade on from the publication of the British HIV Association's National HIV Testing Guidelines: are opportunities to increase the uptake of HIV testing still being missed?", journal= "Access Microbiology", year = "2020", volume = "2", number = "2", pages = "", doi = "https://doi.org/10.1099/acmi.fis2019.po0013", url = "https://www.microbiologyresearch.org/content/journal/acmi/10.1099/acmi.fis2019.po0013", publisher = "Microbiology Society", issn = "2516-8290", type = "Journal Article", eid = "71", abstract = " Background: Guidelines recommend HIV testing in indicator conditions in which the prevalence of undiagnosed HIV exceeds 0.1%. We assessed adherence to national recommendations on HIV testing within the acute medical unit in NHS Fife. Secondly, we performed a look-back exercise to identify missed opportunities for HIV diagnosis in individuals who presented at a late stage of infection. Methods: Data were collected on admissions over a 24-hour-period during four consecutive weeks in 2018. Case records were reviewed and diagnoses were screened against a list of indicators. Additionally, data were obtained from HPS on late HIV diagnoses within NHS Fife from 2013-2018. Records were interrogated for presentations to healthcare services within the 5 years prior to HIV diagnosis. Results: In total, 226 patients were admitted during the study period. All patients were white, with median age 68yrs. 101 indicator conditions were identified, relating to 83 patients (36.7%). Bacterial pneumonia was the most frequently identified indicator (n=40). Only 3 patients were offered HIV testing (3.6%). From 2013-2018, 23 patients were diagnosed with HIV at late stage. The median age at diagnosis was 41yrs and the median CD4 count was 161 cells/mm3. Fifteen patients (65.2%) had presented to hospital in the 5 years preceding diagnosis with an indicator. The most frequently missed indicator was chronic diarrhoea (n=6). Three patients (13%) have died since diagnosis. Conclusions: * Opportunities to increase uptake of HIV testing among people who may have undiagnosed HIV are being missed * Further educational initiatives and review of local HIV testing protocols are indicated ", }