title: Missed opportunities for HIV testing in newly-HIV-diagnosed patients, a cross sectional study.
abstract: BACKGROUND
  In France, 1/3 HIV-infected patients is diagnosed at an advanced stage of the disease. We describe missed opportunities for earlier HIV testing in newly-HIV-diagnosed patients.
  
  
  METHODS
  Cross sectional study. Adults living in France for ≥1 year, diagnosed with HIV-infection ≤6 months earlier, were included from 06/2009 to 10/2010. We collected information on patient characteristics at diagnosis, history of HIV testing, contacts with healthcare settings, and occurrence of HIV-related events 3 years prior to HIV diagnosis. During these 3 years, we assessed whether or not HIV testing had been proposed by the healthcare provider upon first contact in patients notifying that they were MSM or had HIV-related conditions.
  
  
  RESULTS
  1,008 newly HIV-diagnosed patients (mean age: 39 years; male: 79%; MSM: 53%; diagnosed with an AIDS-defining event: 16%). During the 3-year period prior to HIV diagnosis, 99% of participants had frequented a healthcare setting and 89% had seen a general practitioner at least once a year. During a contact with a healthcare setting, 91/191 MSM (48%) with no HIV-related conditions, said being MSM; 50 of these (55%) did not have any HIV test proposal. Only 21% (41/191) of overall MSM who visited a healthcare provider received a test proposal. Likewise, 299/364 patients (82%) who sought care for s had a missed opportunity for HIV testing.
  
  
  CONCLUSIONS
  Under current screening policies, missed opportunities for HIV testing remain unacceptably high. This argues in favor of improving risk assessment, and HIV-related conditions recognition in all healthcare facilities.
authors: ATIP-Avenir Inserm: Modélisation, Aide à la Décision, et Coût-Efficacité en Maladies Infectieuses, 152 rue du professeur Yersin, Loos 59120, France. karen.champenois@gmail.com
authors: Karen
authors: K
authors: Champenois
authors: Anthony
authors: A
authors: Cousien
authors: Lise
authors: L
authors: Cuzin
authors: Stéphane
authors: S
authors: Le Vu
authors: Sylvie
authors: S
authors: Deuffic-Burban
authors: Emilie
authors: E
authors: Lanoy
authors: Karine
authors: K
authors: Lacombe
authors: Olivier
authors: O
authors: Patey
authors: Pascal
authors: P
authors: Béchu
authors: Marcel
authors: M
authors: Calvez
authors: Caroline
authors: C
authors: Semaille
authors: Yazdan
authors: Y
authors: Yazdanpanah
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D015658:HIV Infections / Q000175:diagnosis*; D006291:Health Policy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D055815:Young Adult
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