Abstract #125 - HIV testing and awareness of HIV status in the STI outpatient clinic in Amsterdam.
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Session: 45.1: Prevention in the new millenium (Parallel) on Tuesday @ 16.30-18.30 in PR Chaired by Yolande Obadia, Araceli Rousaud
Authors: Presenting Author: Mrs Titia Heijman - GGD Amsterdam Health Service, Netherlands
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Additional Authors:
Dr Nicole Dukers,
Dr Edwin van Leent,
Prof Dr Roel Coutinho,
Dr Harold Thiesbrummel,
Dr Han Fennema,
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Aim: To evaluate the effects of HIV testing policies and awareness of HIV serostatus at an STI outpatient clinic.
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Method / Issue: Routinely collected data from the STI clinic were analysed together with data from an anonymous HIV surveillance, in which yearly a representative fraction of clinic visitors are anonymously tested for HIV (study period 1991-2005).
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Results / Comments: In 2000 30% of the heterosexuals visiting the STI clinic and 18% of men who have sex with men (MSM) requested to be tested on HIV and this increased to respectively 60% and 50% in 2005. In 2005, 0,4% of the heterosexuals and 6% of the MSM who were tested on request were diagnosed HIV positive. Data from the anonymous surveillance in 2005 show that 24% of HIV-infected MSM and 80% of HIV-infected heterosexuals were unaware of their infection. Of the 24% of MSM who were undiagnosed HIV positive, 16% most likely assumed they were HIV negative based on previous testing and 8% were never tested before.
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Discussion: Before HAART became available HIV testing in the Netherlands was discouraged. In 2000 the policy changed from testing on request to offering the test to high-risk groups. The STI outpatient clinic of the Amsterdam Health Service followed national policy and additionally introduced the HIV-rapid testing in 2005 for at risk-visitors.
Despite the uptake of testing relatively high numbers of visitors are still unaware of their HIV infection. To further reduce undiagnosed HIV infections an opting-out strategy started in 2007 at the STI outpatient clinic. HIV testing has now become part of routine STI screening. Visitors are informed about the screening protocol and may opt-out. Posttest counseling remains standard for all visitors.
Results of this pilot are expected in 2008 and will benefit the discussion of implementing opting-out at other healthcare services.
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