Screening for HIV infection in genitourinary medicine clinics: a lost opportunity? British Co-operative Clinical Group.
OBJECTIVE
To examine the policy and practice of HIV testing in genitourinary medicine clinics in the United Kingdom.


METHODS
All 176 consultants in charge of genitourinary medicine clinics in the United Kingdom were sent a policy and practice questionnaire. A self selected group of 53 clinics conducted a retrospective case note survey of the first 100 patients seen in each clinic in 1998.


METHODS
Genitourinary medicine clinics in the United Kingdom.


METHODS
Consultants in charge of, and case notes of patients attending, genitourinary medicine clinics.


METHODS
None.


METHODS
Number of patients tested for HIV.


RESULTS
Consultants' assessments of their rate of HIV testing often exceeded the actual rates of testing in the clinic as a whole. The majority of patients deemed to be at high risk requested an HIV test. The exception were heterosexuals who had lived in sub-Saharan Africa. Among attenders at high risk of HIV who did not request a test, 57/196 (29%) were not offered one by clinic staff. Two fifths (51/130) of consultants felt the proportion of patients tested in their clinic was too low. The commonest reason given for this was a lack of time, especially that of health advisers.


CONCLUSIONS
A substantial minority of people with HIV infection attending genitourinary medicine clinics fail to have their infection diagnosed. Two major reasons were identified. Firstly, a test was not always offered to those at high risk of HIV. Secondly, a lack of resources, mainly staff, which prevents some clinics from increasing their level of testing.
D000553:Ambulatory Care / Q000379:methods; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D011364:Professional Practice; D012189:Retrospective Studies; D006113:United Kingdom