Leber, W., McMullen, H., Anderson, J., et al. The Lancet HIV (June 2015), 2(6), doi: 10.1016/S2352-3018(15): 059-4.
This cluster-randomized controlled trial examined whether including educational outreach promoting rapid HIV testing within general practice leads to increased and early diagnosis of HIV. Between April and August 2011, the authors randomly assigned 40 general practices in the United Kingdom to either intervention (n=20) or control (n=20) groups. Intervention practices included an HIV education program, follow-up training for an HIV lead nurse or assistant, integration of opt-out rapid HIV testing within routine health checks, and provision of free rapid HIV tests. Control practices offered the usual care only, which included HIV testing on client request. The authors reported that intervention practices made a total of 32 new HIV diagnoses, compared to 14 new diagnoses made by control practices. Additionally, the frequency of HIV diagnosis was significantly higher in the intervention than the control practices (0.30 and 0.07 per 10,000 patients per year, respectively). The authors concluded that promoting opt-out rapid testing in general practice health facilities increased the rate of HIV diagnosis. They recommended implementing routine HIV screening in general practices in areas with high HIV prevalence.