Official websites use. Share sensitive information only on official, secure websites. Cross sectional study. We collected information on patient characteristics at diagnosis, history of HIV testing, contacts with healthcare settings, and occurrence of HIV-related events 3 years prior to HIV diagnosis. During these 3 years, we assessed whether or not HIV testing had been proposed by the healthcare provider upon first contact in patients notifying that they were MSM or had HIV-related conditions.
Under current screening policies, missed opportunities for HIV testing remain unacceptably high. This argues in favor of improving risk assessment, and HIV-related conditions recognition in all healthcare facilities. In the past decade in developed countries, highly active antiretroviral therapies have dramatically decreased HIV infection morbidity and mortality [ 1 - 3 ]. More recently, compelling evidence has demonstrated benefits of early treatment of HIV-infected patients for the global population by reducing HIV transmissions [ 6 , 7 ].
Consequently in some countries like US or France, treatment guidelines have moved toward initiating earlier HIV therapy, i. However, most patients are diagnosed long after the optimal moment of treatment initiation.
Late diagnosis compromises benefits of antiretroviral therapies. In most European countries, risk-factor-based HIV testing strategy alone shows limits to detect HIV-infected people because 1 people do not consider themselves at risk and 2 healthcare providers fail in risk assessment [ 20 - 24 ]. In line with the US CDC recommendations [ 25 , 26 ], in the UK guidelines stated that HIV screening should be considered in general practice and for all general medical admissions in regions where HIV prevalence exceeds two per 1, [ 27 ].
In , new French guidelines recommended one-time routine voluntary HIV screening to be implemented population-wide in France [ 28 , 29 ]. However, these recommendations are not applied because of feasibility and budget impact issues [ 30 - 32 ]. Few studies have evaluated patient consultations during the possibly-HIV-infected period [ 22 , 33 - 36 ], and the bulk of them were carried out in the US or the UK. To assess the situation in France, the objectives of the present study conducted in newly diagnosed HIV-infected patients were to describe: 1 in all patients, frequenting of healthcare settings prior to HIV diagnosis during the period in which they were likely to be HIV-infected; and 2 in at-risk populations MSM and patients with possibly HIV-related conditions, opportunities for testing proposal and consequently earlier HIV diagnosis.
