‘Provider initiated testing and counseling’ in de huisartsenpraktijk op Curaçao als startpunt voor ‘test and treat’ in de bestrijding van hiv

Ruiter, S.E. (Sanne) (2016) ‘Provider initiated testing and counseling’ in de huisartsenpraktijk op Curaçao als startpunt voor ‘test and treat’ in de bestrijding van hiv. thesis, Medicine.

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Abstract

Hiv-incidence on Curaçao is still increasing with an average of 100 new hiv-infections in recent years. Patients are often diagnosed in a late stage with much delay between diagnosis, entry into care and start of antiretroviral therapy (ART). The ‘test and treat’ strategy is based on both tracing hiv-infected persons and immediate start of ART. Theoretically this will lead to a lower viral load in the community and eventually to a lower hiv-incidence. This is the first study where provider initiated testing and counseling (PITC) is introduced in a primary healthcare setting in a middle-prevalent area as the basis of the ‘test and treat’ strategy. Four general practicioner (GP) practices on Curaçao introduced PITC, all presenting patients aged 16 and older were invited for an oral hiv rapidtest. The aim of this pilotstudy is to evaluate the feasibility and effectivity of PITC in the GP practice. After 1.5 year of testing PITC was succesfully implemented in half of the practices and acceptability was high among patients. Motivation and involvement of all GP’s working in one practice are major factors affecting feasibility. Almost 3000 patients were tested of which 8 persons had a positive result. Without PITC 7 of them would not have been tested during the same consultation. Extrapolation of these results to the population of Curaçao shows an hiv-incidence 3 to 5 times higher than the current official numbers. PITC in the GP practice is a feasible and effective strategy to diagnose more hiv-patients and is a good point of entry for the test and treat strategy. We recommend to expand PITC to a larger number of motivated GP practices

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Duits, prof. A.J.
Supervisor name:	Tweede begeleider: and Gerstenbluth, dr. I. and Afdeling Epidemiologie en Onderzoek and Geneeskunde & Gezondheidszaken (G&GZ), Curaçao
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:00
Last Modified:	25 Jun 2020 11:00
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2057

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