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

Background 2022 saw the largest number of HIV cases diagnosed in Ireland on record with a 122% increase on 2021 and a 68% increase compared to the pre-pandemic year of 2019. Late-stage diagnoses and difficulties accessing testing are more common outside of Dublin.

Aim The aim of this survey was to assess practices and attitudes to testing in general practice in the west of Ireland.

Design & setting This cross-sectional mixed-methods study was carried out through University Hospital Galway, which provides all HIV care for the west and north west of Ireland.

Method A postal survey was sent to general practitioners (GPs). The survey was based on a study in 2013.

Results There was a 21.4% response rate (n=136). 79.4% reported a registered patient living with HIV. Patient request and sexual history were the most common indications for testing. 19.1% used guidelines for testing. More respondents had patients living with HIV in 2023 than in 2013 (79.41% vs 56%). In 2013, urban GPs were significantly more likely to have sent a test compared to their rural colleagues. This difference was not observed in 2023.

Qualitative themes identified included low perceived impact of HIV on daily practice. A key theme was a desire for targeted guidelines.

Conclusion GPs report a positive attitude to HIV testing but have concerns regarding under-testing. Urban and rural GPs reported different testing practices but this may be lessening over time. Guideline usage was low. We believe this study highlights areas to improve testing in this region.