PhD C.C.E. (Carlijn) Jordans

Below is a brief summary of the dissertation:

Timely diagnosis is essential to identify individuals with HIV and start treatment, preventing late-stage HIV and AIDS. However, many individuals with HIV show missed opportunities for provider-initiated testing. As a result, strategies to improve HIV testing and prevent late diagnosis are needed.

The first part of this thesis reviews challenges to HIV testing, such as HIV stigma among healthcare workers and the impact of the COVID-19 pandemic, which disrupted testing rates. A study of European guidelines showed that many countries do not include HIV testing in their standard medical protocols, even for patients showing symptoms of HIV-related conditions, which is a significant issue for early detection.

The second part looks at solutions to improve HIV testing rates. One successful strategy was implementing HIV teams in Dutch hospitals, which increased testing rates from 50% to 81%. Another intervention involved training general practitioners in HIV testing, though this showed limited success in primary care centers. The thesis also explores point-of-care testing, where patients at risk, like those with cervical dysplasia, were willing to test for HIV, though some doctors hesitated to offer HIV testing.

In conclusion, the thesis emphasizes reducing HIV stigma, improving HIV testing rates in hospitals, and updating national health guidelines to include routine HIV testing. It also suggests further research into using technology and artificial intelligence to improve testing efficiency and accuracy.