Recognising the early symptoms of HIV faster ensures that people can start treatment earlier. Early treatment prevents deterioration of the immune system and gives people an excellent life expectancy. If people are treated in time, they can live as long as people without HIV. Moreover, effective ART treatment largely reduces or even eliminates the chance of transmitting infections.
The H-TEAM promotes testing by raising awareness of the (early) symptoms and the importance of early testing among professionals and specific target groups. The aims are:
– More HIV testing and an increase in the percentage of people who are aware of their HIV status
– Being able to diagnose HIV earlier
We accomplish this by focusing on HIV testing offered by professionals (provider-initiated testing), and testing initiated and implemented by individuals themselves (client-initiated testing).
Every year, some 1,000 people are newly diagnosed with HIV in the Netherlands. Forty-four per cent of the people living with HIV go to hospital for treatment too late. In fact, it is particularly important to trace HIV at an early stage and to be able to start treatment in time.
This does not only benefit people’s personal health, but also drastically diminishes transmissions to sexual partners.
Of all people who are diagnosed with HIV, about one third is diagnosed by a general practitioner, one third in an STD polyclinic of a GGD (local Public Health Service), and one third in a hospital. An estimated 50 to 70 per cent of all STD consultations in the Netherlands takes place in a general practice. This means general practitioners play an important role in diagnosing HIV infections in the Netherlands. However, recent studies demonstrate that many opportunities for offering HIV testing have been insufficiently seen and/or used by general practitioners. Patients and social workers still experience many barriers, such as fear, stigmatisation, limited risk assessment and risk perception, and lack of knowledge about new HIV treatment and prevention opportunities. Furthermore, testing in case of indicator diseases is not yet a standard procedure among general practitioners and medical specialists.
The H-TEAM encourages more active tracing of HIV infections and stimulates people to talk about the importance of testing within the communities themselves.
We organise so-called Diagnostic Test Meetings (in Dutch Diagnostische Toets Overleggen – DTOs) for general practitioners in Amsterdam. These are refresher courses for groups of general practitioners. Through mirroring techniques, general practitioners take a closer look at their test request behaviour related to HIV and other STDs, and develop a practice improvement plan. General practitioners who have participated in a refresher course are very positive about them. By using the testing request data, the H-TEAM maps trend information. In collaboration with GGD Amsterdam, we are focusing on intensifying partner notifications in cases of (acute) HIV in 2017. We have a stronger focus on testing for, by and in the communities this year. We mainly use a rapid HIV test for this, preferably in combination with other health tests. In 2017, we are actively working on indicator disease testing by medical specialists.
Every year, we organise an HIV testing week. During one week, everyone interested in having an HIV test in Amsterdam can have a free and anonymous test by using a rapid HIV test.
So far, about 20 per cent of all general practitioners in Amsterdam have participated in a DTO refresher course. The participants are positive about the courses.
So far, about 20 per cent of all general practitioners in Amsterdam have participated in a DTO refresher course. The participants are positive about the courses. The number of DTO refresher courses will increase in the years to come, and we expect improved testing behaviours among general practitioners, due to this programme.
In 2015 and 2016, the HIV testing weeks ran at several locations in Amsterdam: in general practices, at the GGD’s STD polyclinics, in hospitals and at outreach locations. In 2017, another HIV testing week will take place. This time, raising awareness of HIV testing will be the main objective.