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Abstract

Background

Adequate 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.

Aim

To evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in European countries.

Methods

Between 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).

Results

Of 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.

Conclusion

Fewer 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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2022-12-01
2024-04-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.48.2200338
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National medical specialty guidelines of HIV indicator conditions in Europe lack adequate HIV testing recommendations: a systematic guideline review
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Carlijn+C.E.+Jordans&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jordans Carlijn C.E.</a>, <a href="/search?value1=Marta+Vasylyev&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vasylyev Marta</a>, <a href="/search?value1=Caroline+Rae&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rae Caroline</a>, <a href="/search?value1=Marie+Louise+Jakobsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jakobsen Marie Louise</a>, <a href="/search?value1=Anna+Vassilenko&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vassilenko Anna</a>, <a href="/search?value1=Nicolas+Dauby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dauby Nicolas</a>, <a href="/search?value1=Anne+Louise+Grevsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Grevsen Anne Louise</a>, <a href="/search?value1=Stine+Finne+Jakobsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jakobsen Stine Finne</a>, <a href="/search?value1=Anne+Raahauge&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Raahauge Anne</a>, <a href="/search?value1=Karen+Champenois&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Champenois Karen</a>, <a href="/search?value1=Emmanuelle+Papot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papot Emmanuelle</a>, <a href="/search?value1=Jakob+J.+Malin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Malin Jakob J.</a>, <a href="/search?value1=T.+Sonia+Boender&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boender T. Sonia</a>, <a href="/search?value1=Georg+M.N+Behrens&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Behrens Georg M.N</a>, <a href="/search?value1=Henning+Gruell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gruell Henning</a>, <a href="/search?value1=Anja+Neumann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Neumann Anja</a>, <a href="/search?value1=Christoph+D.+Spinner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Spinner Christoph D.</a>, <a href="/search?value1=Frederik+Valbert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valbert Frederik</a>, <a href="/search?value1=Karolina+Akinosoglou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Akinosoglou Karolina</a>, <a href="/search?value1=Evangelia+G.+Kostaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kostaki Evangelia G.</a>, <a href="/search?value1=Silvia+Nozza&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nozza Silvia</a>, <a href="/search?value1=Andrea+Giacomelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Giacomelli Andrea</a>, <a href="/search?value1=Giuseppe+Lapadula&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lapadula Giuseppe</a>, <a href="/search?value1=Maria+Mazzitelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mazzitelli Maria</a>, <a href="/search?value1=Carlo+Torti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Torti Carlo</a>, <a href="/search?value1=Raimonda+Matulionyte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Matulionyte Raimonda</a>, <a href="/search?value1=Elzbieta+Matulyte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Matulyte Elzbieta</a>, <a href="/search?value1=Berend+J.+Van+Welzen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Welzen Berend J.</a>, <a href="/search?value1=Kathryn+S.+Hensley&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hensley Kathryn S.</a>, <a href="/search?value1=Magdalena+Thompson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thompson Magdalena</a>, <a href="/search?value1=Magdalena+Ankiersztejn-Bartczak&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ankiersztejn-Bartczak Magdalena</a>, <a href="/search?value1=Agata+Skrzat-Klapaczy%C5%84ska&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Skrzat-Klapaczyńska Agata</a>, <a href="/search?value1=Oana+S%C4%83ndulescu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Săndulescu Oana</a>, <a href="/search?value1=Adrian+Streinu-Cercel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Streinu-Cercel Adrian</a>, <a href="/search?value1=Anca+Streinu-Cercel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Streinu-Cercel Anca</a>, <a href="/search?value1=Viktor+Daniel+Miron&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Miron Viktor Daniel</a>, <a href="/search?value1=Anastasia+Pokrovskaya&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pokrovskaya Anastasia</a>, <a href="/search?value1=Anna+Hachfeld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hachfeld Anna</a>, <a href="/search?value1=Antonina+Dorokhina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dorokhina Antonina</a>, <a href="/search?value1=Maryna+Sukach&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sukach Maryna</a>, <a href="/search?value1=Emily+Lord&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lord Emily</a>, <a href="/search?value1=Ann+K.+Sullivan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sullivan Ann K.</a>, <a href="/search?value1=Casper+Rokx&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rokx Casper</a>, <a href="/search?value1=on+behalf+of+the+Guidelines+Review+Group+for+the+projects%3A+Optimising+testing+and+linkage+to+care+for+HIV+across+Europe+%28OptTEST+by+HiE%29+and+the+Joint+Action+on+integrating+prevention%2C+testing+and+linkage+to+care+strategies+across+HIV%2C+viral+hepatitis%2C+TB+and+STIs+in+Europe+%28INTEGRATE%29&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Guidelines Review Group for the projects: Optimising testing and linkage to care for HIV across Europe (OptTEST by HiE) and the Joint Action on integrating prevention, testing and linkage to care strategies across HIV, viral hepatitis, TB and STIs in Europe (INTEGRATE)</a></span>. National medical specialty guidelines of HIV indicator conditions in Europe lack adequate HIV testing recommendations: a systematic guideline review. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(48):pii=2200338. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.48.2200338" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.48.2200338</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 06 Apr 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 Sept 2022 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.48.2200338
/content/10.2807/1560-7917.ES.2022.27.48.2200338
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