An audit cycle reviewing the offer of HIV testing

Published Date: 26th October 2016

Publication Authors: Botchey SA,

​Objectives

To determine if the offer of an HIV test at a community sexual health clinic adhered to national guidelines (Offer of HIV testing 97% BASHH). In the first audit cycle (October 2014) the offer of an HIV test (84%) failed to comply with national guidelines. In addition, the uptake of HIV testing was only 12%. Based on the findings, HIV awareness among attendees to the clinic was increased. Dry Blood Spot tests were also introduced for patients who declared needle-phobia. 

Methods

A retrospective review of the electronic patient record (EPR) system was conducted during the month of September 2015. The first 100 patients with a code P1B (HIV test offered and refused) and PIC (HIV test inappropriate) were selected. A Microsoft Excel spreadsheet was constructed in which the following was recorded: demographics, sexual behaviour, drug use, offer of an HIV test, offer of dry blood spot testing, who offered the test and reasons for decline.

Results

The offer of HIV testing remained at 84%. The HIV test uptake was 31%. Of the patients who declined HIV testing, a number of reasons were cited. The most common reason was 'does not feel there is a risk' at 53%. Of these patients that did not feel there was a risk, only 12% admitted to using condoms. Only 8% of patients were documented to have been offered a dry blood spot test. The age range of the patients audited varied between 17 and 82 years, with 66% being female. The majority of the tests were offered by nurses 86%, doctors 10% and 4% not documented. 

Conclusion

The offer of an HIV test was satisfactory; however, this failed to comply with national guidelines falling short by 13%. The uptake of the HIV testing improved with a 19% increase of uptake from the first audit cycle. The introduction of dry blood spot testing and increasing HIV awareness after the first audit may have led to the better uptake in the second cycle. However only 8% of patients were documented to have been offered the dry blood spot test and this can be improved by introducing a dry blood spot test offer section in the consultation proforma. In addition increased awareness to patients and staff can be improved via posters, flyers and having computer pop-up reminders.

Friday, D; Botchey, SA. (2016). An audit cycle reviewing the offer of HIV testing in an integrated sexual health service . European Journal of Contraception and Reproductive Health Care. 21 (Suppl 1), 132

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