Targeting fast-track goals: Missed opportunities for HIV testing in the Community of Madrid

Abstract

Introduction: In Spain HIV testing is recommended to people with risk behaviors for HIV and with indicator conditions (IC) related to HIV infection. Missed diagnostic opportunities (MO) are defining as situations where these recommendations are not followed.

Objective: To characterize MO due to risk behaviors (directed) and due to IC (indicated) among people diagnosed with HIV in the Region of Madrid.

Methods: A total of 109 participants newly diagnosed with HIV were recruited from 7 health centers (April 2018-March 2019) by a telephone survey. Diagnostic opportunities were defined as any contact with the healthcare system in which an HIV test should have been carried out. Frequency of MO was calculated within the previous 2 years from HIV diagnosis.

Results: Of the 32 directed and indicated diagnostic opportunities, 96.9% and 57.8% respectively resulted in MO. Overall, 83.8% of diagnostic opportunities resulted in MO.

Conclusion: MO, both directed and indicated, are an important area for improvement to reduce late diagnosis.

Keywords: AIDS; Delayed diagnosis; HIV; HIV testing; Missed opportunities; Oportunidades perdidas; Pruebas de VIH; Retraso en el diagnóstico; Sida; VIH.