title: Monitoring HIV testing in diverse healthcare settings: results from a sentinel surveillance pilot study.
abstract: OBJECTIVE
  To assess the feasibility and utility of sentinel laboratory surveillance of HIV testing as a tool for understanding patterns and trends in HIV testing in a range of healthcare services.
  
  
  METHODS
  Data on all anti-HIV antibody tests carried out by the Leeds Teaching Hospital Trust laboratory over a 12-month period were collated and analysed by demographic information and place of test. Individuals who tested positive were matched to the national database of HIV diagnoses to identify the proportion newly diagnosed with HIV.
  
  
  RESULTS
  41,013 individuals over 1 year of age were tested at least once for HIV during the study period, of whom 0.8% (n=312) were positive. The majority of individuals (77%) were tested in a genitourinary medicine (GUM) clinic or as part of antenatal care, while routine testing of people undergoing haemodialysis, fertility treatment or occupational health screening accounted for a further 13% of those tested. Few individuals (<4%) were tested in general practice. Of the 312 people testing positive, 286 could be matched to the HIV national database and 173/286 (60%) were identified as newly diagnosed.
  
  
  CONCLUSIONS
  Little HIV testing is currently performed outside GUM and antenatal settings. Monitoring of HIV testing is essential given new guidelines recommending the expansion of testing in a wide range of settings. Sentinel laboratory surveillance can provide useful demographic data on people tested for HIV and can assess trends in testing over time. Data on HIV testing could be incorporated into existing hepatitis sentinel surveillance, allowing rapid scale-up of this surveillance scheme with minimal effort.
authors.affiliation: Immunisation, Hepatitis and Blood Safety Department, Health Protection Agency, Centre for Infections, London, UK. emilytweed43@gmail.com
authors.forename: Emily
authors.initials: E
authors.lastname: Tweed
authors.forename: Antony
authors.initials: A
authors.lastname: Hale
authors.forename: Martin
authors.initials: M
authors.lastname: Hurrelle
authors.forename: Ruth
authors.initials: R
authors.lastname: Smith
authors.forename: Valerie
authors.initials: V
authors.lastname: Delpech
authors.forename: Murad
authors.initials: M
authors.lastname: Ruf
authors.forename: Paul
authors.initials: P
authors.lastname: Klapper
authors.forename: Mary
authors.initials: M
authors.lastname: Ramsay
authors.forename: Lisa
authors.initials: L
authors.lastname: Brant
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data; D042241:Early Diagnosis; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D018571:Sentinel Surveillance; D055815:Young Adult
chemical_list: D015483:HIV Antibodies