Implicit bias in HIV testing based on indicator conditions in primary care : a population-based study in Catalonia, Spain, 2017 to 2021
Agustí, Cristina (Institut Germans Trias i Pujol)
Cunillera, O. (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Mascort Roca, Juanjo (Universitat de Barcelona)
Carrillo Muñoz, Ricard (Institut Català de la Salut)
Casabona-Barbarà, Jordi (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)

Date:	2025
Abstract:	HIV testing guided by indicator condition (IC) is recommended by the World Health Organization to facilitate earlier diagnosis. However, it is unclear to what extent these guidelines are followed in routine primary care (PC). To estimate the prevalence and distribution of ICs in PC in Catalonia, Spain, identify factors associated with, and prevalence of, an HIV test being administered, or not, within 4 months of IC diagnosis and assess trends over time. A population-based cross-sectional study was conducted using data from the Information System for the Development of Research in Primary Care, covering 5. 8 million individuals in Catalonia. We identified IC episodes recorded from 1 January 2017 to 31 August 2021 among patients aged 16-65 years. For each IC episode, we assessed whether an HIV test was performed within 4 months. We identified 372,712 IC episodes; 84,694 (22. 7%) led to an HIV test within 4 months. Testing was higher for: men (26. 3% vs 19. 4% for women); migrants (27. 7% vs 21. 3% for Spanish citizens); younger patients (29. 2% for 16-30-year-olds vs 13. 7% for those over 50 years). Testing rates were highest for episodes involving syphilis (68. 4%), genital herpes (50. 6%), chlamydia (48. 2%) and gonorrhoea (43. 1%). Factors associated with increased testing included male sex, higher socioeconomic deprivation area, presence of an acute sexually transmitted infection and multiple ICs. Substantial gaps remain in HIV testing based on ICs in PC in Catalonia. Targeted interventions are needed to improve adherence to IC-guided testing, enabling early HIV diagnosis and treatment.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	HIV testing ; Primary care ; Indicator conditions ; Implicit bias
Published in:	Eurosurveillance, Vol. 30 (June 2025) , art. 2400585, ISSN 1560-7917

DOI: 10.2807/1560-7917.ES.2025.30.24.2400585
PMID: 40539311

13 p, 281.3 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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