22 jaar hiv-gerelateerde consulten in de huisartsenpraktijk*

Objective

To examine the role of general practitioners (GPs) in HIV counselling and testing over a 22-year period.

Design

Dynamic cohort study.

Method

We collected data from 42 general practices participating in the Dutch Sentinel General Practice Network at Netherlands Institute for Health Services Research (NIVEL) with a nationally representative patient population by age, gender, regional distribution and population density. These practices registered HIV-related consultations from 1988 to 2009 and completed questionnaires in which patient characteristics, interventions and test results were recorded. Trends over time and effects of population density (3 categories) were assessed by multilevel analysis to control for clustering of observations within general practices.

Results

Time trend analyses showed an increase in the number of HIV-related consultations and in the number of HIV tests per 10 000 registered patients from 1988 to 1996, followed by a period of decline and an increase again between 2007 and 2009. Over the whole period, the number of HIV-related consultations was highest in urban areas with a maximum of 18 per 10 000 patients in 1996. The proportion of patients high at risk – men who have sex with men – decreased. The proportion of HIV-related consultations initiated by the GPs increased from 11% in 1988 to 23% in 2009.

Conclusion

During this 22-year period, HIV-related consultations and provider-initiated HIV testing in Dutch general practice have increased. However, more attention to sexual health in general practice focusing on risk groups and on more routine testing in high prevalence areas is required.

Conflict of interest and financial support: G.A. Donker received an unconditional grant from Stichting Soa Aids Nederland. The NIVEL Dutch Sentinel General Practice Network are being financed by the Dutch Ministry of Health, Welfare and Sport.