Over the past decade, the landscape of HIV testing in the west of Ireland has undergone a transformative journey, shedding light on both challenges and triumphs. This mixed-method survey, conducted between 2013 and 2023, provides a comprehensive exploration of practices, attitudes, and the evolving dynamics of HIV testing in primary care settings.

Background and Motivation

The year 2022 marked a pivotal point with the highest number of HIV cases diagnosed in Ireland, highlighting a 122% surge compared to 2021, and a 68% increase from 2019. These figures underscore the urgent need for enhanced testing, particularly outside Dublin, where late-stage diagnoses and testing accessibility issues are prevalent.

Methodology

Conducted under the auspices of University Hospital Galway, this cross-sectional study utilised a postal survey distributed to general practitioners (GPs) across the west and northwest of Ireland. The survey aimed to capture a decade's worth of insights, building on a previous study from 2013.

Key Findings

The survey achieved a 21.4% response rate, with 79.4% of respondents noting they had registered patients living with HIV. Notably, patient request and sexual history emerged as the primary triggers for HIV testing, yet only 19.1% of GPs adhered to formal testing guidelines.

• There was a noticeable increase in the number of GPs with HIV-positive patients from 56% in 2013 to 79.4% in 2023.
• Initial disparities in testing practices between urban and rural GPs observed in 2013 have diminished by 2023.

Qualitative Insights

Qualitative themes from the survey revealed a low perceived impact of HIV on daily practice, yet GPs expressed a strong desire for more targeted guidelines. Concerns about under-testing were prevalent, indicating areas ripe for improvement.

Conclusion and Future Directions

The findings from this study highlight a positive shift in attitudes towards HIV testing among GPs, yet underscore persistent gaps in guideline adherence and testing practices. Addressing these gaps through targeted education and resources could significantly enhance HIV testing efficacy in this region.

As we look to the future, fostering collaboration between urban and rural health practitioners, alongside the development of comprehensive guidelines, will be crucial. This study not only sheds light on the current state of HIV testing in the west of Ireland but also paves the way for more informed and proactive healthcare strategies in the years to come.

Source: HIV testing in primary care in the west of Ireland: a mixed-method survey between 2013 and 2023