National medical specialty guidelines of HIV indicator conditions in Europe lack adequate HIV testing recommendations: a systematic guideline review

BackgroundAdequate identification and testing of people at risk for HIV is fundamental for the HIV care continuum. A key strategy to improve timely testing is HIV indicator condition (IC) guided testing.AimTo evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in Europea...

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Vydané v:Euro surveillance : bulletin européen sur les maladies transmissibles Ročník 27; číslo 48; s. 1
Hlavní autori: Jordans, Carlijn C.E., Vasylyev, Marta, Rae, Caroline, Jakobsen, Marie Louise, Vassilenko, Anna, Dauby, Nicolas, Grevsen, Anne Louise, Jakobsen, Stine Finne, Raahauge, Anne, Champenois, Karen, Papot, Emmanuelle, Malin, Jakob J., Boender, T. Sonia, Behrens, Georg M.N, Gruell, Henning, Neumann, Anja, Spinner, Christoph D., Valbert, Frederik, Akinosoglou, Karolina, Kostaki, Evangelia G., Nozza, Silvia, Giacomelli, Andrea, Lapadula, Giuseppe, Mazzitelli, Maria, Torti, Carlo, Matulionyte, Raimonda, Matulyte, Elzbieta, Van Welzen, Berend J., Hensley, Kathryn S., Thompson, Magdalena, Ankiersztejn-Bartczak, Magdalena, Skrzat-Klapaczyńska, Agata, Săndulescu, Oana, Streinu-Cercel, Adrian, Streinu-Cercel, Anca, Miron, Viktor Daniel, Pokrovskaya, Anastasia, Hachfeld, Anna, Dorokhina, Antonina, Sukach, Maryna, Lord, Emily, Sullivan, Ann K., Rokx, Casper
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 01.12.2022
European Centre for Disease Prevention and Control (ECDC)
Predmet:
Antiretroviral drugs
Clinical practice guidelines
Diagnostic tests
Europe - epidemiology
Europe, Eastern
Female
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Testing
Human immunodeficiency virus
Humans
Medicine
Pregnancy
Sexual behavior
Systematic review
Europe, Eastern
Europe
guidelines
indicator conditions
AIDS-defining conditions
HIV testing recommendations
HIV
Europe
ISSN:1560-7917, 1025-496X, 1560-7917
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Shrnutí:BackgroundAdequate identification and testing of people at risk for HIV is fundamental for the HIV care continuum. A key strategy to improve timely testing is HIV indicator condition (IC) guided testing.AimTo evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in European countries.MethodsBetween 2019 and 2021, European HIV experts reviewed guideline databases to identify all national guidelines of 62 HIV ICs. The proportion of HIV IC guidelines recommending HIV testing was reported, stratified by subgroup (HIV IC, country, eastern/western Europe, achievement of 90-90-90 goals and medical specialty).ResultsOf 30 invited European countries, 15 participated. A total of 791 HIV IC guidelines were identified: median 47 (IQR: 38-68) per country. Association with HIV was reported in 69% (545/791) of the guidelines, and 46% (366/791) recommended HIV testing, while 42% (101/242) of the AIDS-defining conditions recommended HIV testing. HIV testing recommendations were observed more frequently in guidelines in eastern (53%) than western (42%) European countries and in countries yet to achieve the 90-90-90 goals (52%) compared to those that had (38%). The medical specialties internal medicine, neurology/neurosurgery, ophthalmology, pulmonology and gynaecology/obstetrics had an HIV testing recommendation uptake below the 46% average. None of the 62 HIV ICs, countries or medical specialties had 100% accurate testing recommendation coverage in all their available HIV IC guidelines.ConclusionFewer than half the HIV IC guidelines recommended HIV testing. This signals an insufficient adoption of this recommendation in non-HIV specialty guidelines across Europe.
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SourceType-Scholarly Journals-1
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These authors contributed equally to this article and share last authorship.
Correspondence: Casper Rokx (c.rokx@erasmusmc.nl)
ISSN:1560-7917
1025-496X
1560-7917
DOI:10.2807/1560-7917.ES.2022.27.48.2200338