Acquired Immunodeficiency Syndrome, AIDS Defining Illness, Candida Infection, Dermatitis, Seborrheic, Diarrhea Chronic, Herpes Zoster, HIV Indicator Condition, HIV Infections, Infectious Mononucleosis, Leukopenia, Lymphadenopathy, Pneumonia, Primary Health Care, Psoriasis, Sexually Transmitted Diseases, Viral, Thrombocytopenia, Uterine Cervical Dysplasia, Weight Loss
Conditions
Keywords
General Practitioner, Medical Specialist, HIV indicator condition, HIV risk group, AIDS
Brief summary
Patients are frequently evaluated by physicians for medical work-up of HIV indicator conditions in hospital and in primary care at the general practitioner. Testing for HIV is indicated with HIV indicator disorder but often omitted in clinical work-up. Besides the fact that HIV testing is forgotten, there are other reasons such as an underestimation of the risk of HIV in the event of indicator disorders, stigma and difficulties in discussing the test with a patient. Also and more relevant for primary care than for the hospital, practical challenges can exist for a patient to go to a laboratory, or costs are a hurdle. This project focuses on improving HIV indicator condition driven testing in different settings of the HIV epidemic, initially in the Netherlands as low HIV prevalence setting followed by an assessment of its benefit in different international settings. A specific focus will also be on the Rotterdam area in the Netherlands which has a high prevalence of undiagnosed HIV in the Netherlands. The ultimate aim is to decrease the number of undiagnosed HIV in populations, improve the 90-90-90 HIV cascade of care goals particularly its first pillar, and to help supporting the UNAIDS goal to end HIV/AIDS
Interventions
BEHAVIORALPeer to peer feedback
HIV experts contact non-HIV specialised treating physicians on individual patient care to recommend HIV testing
DIAGNOSTIC_TESTHIV rapid test
Free HIV rapid tests are provided to non-HIV specialised treating physicians to use in individual patient care in patients at risk of HIV
Sponsors
Huisartspraktijk Gezondheidscentrum Mathenesserlaan
TU Delft department of Artificial Intelligence and MyTomorrows
Huisartsen Groep Rotterdam
AwareHIV Project Group
Huisartspraktijk Handellaan
Huisartspraktijk Leerdam
Huisartspraktijk Capelle ad IJssel
Leiden University Medical Center
Maasstadziekenhuis
Rijnstate Hospital
Medical Center Haaglanden
Erasmus Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of an HIV indicator conditions.
Exclusion criteria
* Below 18 years of age * Recent HIV test (\< 12 months, except for mononucleosis-like disease and STDs)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The number of adequately performed HIV tests of identified HIV indicator conditions in relation to the total number of identified HIV indicator conditions by physicians in hospital settings during the project. | 3 year |
| The number of adequately performed HIV tests of identified HIV indicator conditions in relation to the total number of identified HIV indicator conditions by general practitioners in primary care during the project. | 3 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The percentage of adequately HIV tested patients per HIV indicator condition and per medical specialism. | 31 year | — |
| The prevalence of HIV indicator conditions in primary care and hospitals. | 3 year | — |
| A sensitive and specific supervised artificial Intelligence tool that recognizes risk factors for HIV and HIV indicator conditions through natural language processing (NLP) and supports the hospital and primary care in proactive HIV testing policies. | 3 year | — |
| Acceptance of HIV testing in by patients, medical specialist and in primary care. | 3 year | Assessed by questionnaire |
| The costs of pro-active HIV indicator case finding and relation to the savings and QALY's gained | 3 year | Costs of the program in relation to the savings in costs and QALY's lost as a consequence of earlier HIV diagnosis with subsequent prevented HIV transmission, AIDS comorbidity and hospital admissions. |
| The incidence of HIV indicator conditions in primary care and hospitals. | 3 year | — |
| The number of positive HIV tests in relation to the total number of HIV tests for identified HIV indicator conditions. | 3 year | — |
Other
| Measure | Time frame |
|---|---|
| The number of HIV tests in relation to the total number of HIV tests done by gender, ethnical background, age, previous HIV test and HIV indicator conditions of the patient, primary care setting and hospital setting. | 3 year |
| Center for Disease Control and Prevention (CDC) HIV classification of the patients with an HIV positive test. | 3 year |
Countries
Netherlands
Contacts
Primary ContactCasper Rokx, MD PhD
Outcome results
None listed