Family Practice, Vol 14, 255-257, Copyright © 1997 by World Organization of Family Doctors
S Madge, A Olaitan, A Mocroft, A Phillips and M Johnson
BACKGROUND: Anonymous antenatal testing for HIV antibodies suggests that
the majority of HIV-positive women in the UK remain undiagnosed. Primary
care reaches the majority of the population and women present more often
than men. Sexual health matters are frequently raised, so there is an
opportunity to discuss concerns with respect to HIV. Women often present
with advanced HIV disease and with antiviral treatments proving to be more
effective, there is now an even greater incentive to diagnose HIV early.
OBJECTIVE: We aimed to look at access to medical care 1 year prior to HIV
diagnosis in 100 HIV-positive women and to establish whether a discussion
regarding HIV was recalled. METHOD: The setting was an established clinic
for HIV-positive women in the Royal Free Hospital, London. In a 6-month
period a questionnaire was completed by 100 women with their clinic doctor.
RESULTS: Women were young (mean age 31). Most (84%) were infected by
heterosexual sex. Forty-six per cent of the women presented with
symptomatic HIV or AIDS and 50% were black Africans, hence there is a large
ethnic bias in this sample. General practice was accessed by 65% of the
women 1 year prior to HIV diagnosis. Few (14%) women recalled a discussion
concerning HIV. Secondary care settings such as gynaecology and general
outpatients were also frequently attended, but again HIV was apparently
rarely discussed. There was no significant difference when variables such
as time since diagnosis, health care setting, or ethnic group were
concerned with respect to recall of a discussion concerning HIV.
CONCLUSIONS: Despite coming from 'high risk' groups or presenting with
symptomatic disease in the year prior to HIV diagnosis, few women recalled
discussing HIV in either primary or secondary care settings. As these sites
were commonly accessed, we feel that doctors and other health care workers
should be encouraged and trained to raise HIV more routinely in their
consultations.
ORIGINAL CLINICAL RESEARCH
Access to medical care one year prior to diagnosis in 100 HIV-positive women
Department of Thoracic Medicine, Royal Free Hospital, London, UK.
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