Format

Send to

Choose Destination
Br J Gen Pract. 2016 Dec;66(653):e920-e929. Epub 2016 Sep 26.

Impact of a primary care national policy on HIV screening in France: a longitudinal analysis between 2006 and 2013.

Author information

1
INSERM, Centre for Research in Epidemiology and Population Health, University Paris-Saclay, University Paris-Sud, UVSQ, Paris, France.
2
INSERM, Centre for Research in Epidemiology and Population Health, University Paris-Saclay, University Paris-Sud, UVSQ, Paris, France, and Faculty of Health Sciences Simone Veil, Department of Family Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France.
3
CHU Ambroise Paré, Boulogne-Billancourt, France.

Abstract

BACKGROUND:

Early diagnosis of HIV infection is a major public health issue worldwide. In 2009, the French National Authority for Health (Haute Autorité de Santé) developed specific guidelines and recommended mass screening of 15-70-year-olds across the general population. The guidelines were supported by communication directed at healthcare professionals, especially GPs.

AIM:

To assess the impact of the national mass screening policy on HIV testing.

DESIGN AND SETTING:

The study used data from the French National Health Insurance Fund database, from January 2006 to December 2013. Males and females aged 15-70 years, excluding HIV-positive individuals and pregnant females, were followed up throughout the 2006-2013 period. During the study period, 2 176 657 person-years and a total of 329 748 different individuals were followed up.

METHOD:

Standardised and non-standardised rates of HIV screening were calculated for each year; the impact of the policy was assessed using adjusted segmented regression analyses.

RESULTS:

Overall, annual HIV screening rates increased over the study period, from 4.2% (95% confidence interval [CI] = 4.2 to 4.3) in 2006 to 5.8% (95% CI = 5.7 to 5.9) in 2013 with a more pronounced trend after 2010 (P<0.0001). This increase was more significant for those who regularly consulted a GP. For these individuals, the policy led to a 20.4% increase (95% CI = 17.0 to 23.8) in HIV screening in 2013 compared with only a 4.5% increase (95% CI = 4.4 to 4.5) for those who did not consult a GP regularly in 2013.

CONCLUSION:

The results show that the mass screening policy coordinated by GPs had a significant impact on HIV testing in France, which could result in positive impacts on public and individual health outcomes.

KEYWORDS:

HIV testing; longitudinal studies; mass screening; policy evaluation; primary care; segmented regression analysis

PMID:
27672140
PMCID:
PMC5198641
DOI:
10.3399/bjgp16X687529
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center