Missed opportunities for HIV testing among patients newly presenting for HIV care at a Swiss university hospital: a retrospective analysis

Objectives: To determine the frequency of missed opportunities (MOs) among patients newly-diagnosed with HIV, risk factors for presenting MOs, and the association between MOs and late presentation to care.
Design: Retrospective analysis
Setting: HIV outpatient clinic at a Swiss tertiary hospital
Participants: Patients aged ≥18 years old newly presenting for HIV care between 2010 and 2015
Measures: Number of medical visits, up to five years preceding HIV diagnosis, at which HIV testing had been indicated, according to Swiss HIV testing recommendations. A visit at which testing was indicated but not performed was considered a MO for HIV testing.
Results: Complete records were available for all 201 new patients of whom 51% were male and 33% from sub-Saharan Africa. Thirty patients (15%) presented with acute HIV infection while 119 patients (59%) were late presenters (LPs) (CD4 counts <350 cells/mm3 at diagnosis). Ninety-four patients (47%) had presented at least one MO, of whom 44...