HIV testing in primary care in the West of Ireland: a mixed-method survey between 2013 and 2023

Abstract

Background: The year 2022 saw the largest number of human immunodeficiency virus (HIV) cases diagnosed in the Republic of Ireland on record, with a 122% increase on 2021 and a 68% increase compared with the pre-pandemic year of 2019. Late-stage diagnoses and difficulties accessing testing are more common outside of Dublin.

Aim: To assess practices and attitudes to testing in general practice in the West of Ireland.

Design & setting: This cross-sectional mixed-methods study was carried out through University Hospital Galway, which provides all HIV care for the West and North-West of Ireland.

Method: A postal survey was sent to GPs. The survey was based on a study in 2013.

Results: There was a 21.4% response rate (n = 136) to the survey, which found 79.4% reported a registered patient living with HIV. Sexual history and patient request were the most common indications for testing and 19.1% used guidelines for testing. More responders had patients living with HIV in 2023 than in 2013 (79.4% versus 59.2%). In 2013, urban GPs were significantly more likely to have sent a test compared with their rural colleagues (P = 0.005). This difference was not observed in 2023. Qualitative themes identified included low perceived impact of HIV on daily practice. A key theme was a desire for national guidelines.

Conclusion: GPs report a positive attitude to HIV testing but have concerns regarding undertesting. Urban and rural GPs reported different testing practices but this may be lessening over time. Guideline usage was low. We believe this study highlights areas to improve testing in this region.

Keywords: HIV; general practitioners; primary health care; public health.