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3 results on '"Heidenrijk, M."'

1. Understanding the effect of an educational intervention to optimize HIV testing strategies in primary care in Amsterdam – results of a mixed-methods study.

Author

Bogers, Saskia, Nieuwkerk, Pythia, van Dijk, Nynke, Schim van der Loeff, Maarten, Geerlings, Suzanne, van Bergen, Jan, the HIV Transmission Elimination Amsterdam (H-TEAM) Consortium, van Benthem, T., Bons, D., de Bree, G. J., Brokx, P., Davidovich, U., Deug, F., Heidenrijk, M., Hoornenborg, E., Prins, M., Reiss, P., van Sighem, A., van der Valk, M., and de Wit, J.

Subjects
DIAGNOSIS of HIV infections, ATTITUDES of medical personnel, RESEARCH methodology, SELF-evaluation, MEDICAL screening, INTERVIEWING, PRIMARY health care, DESCRIPTIVE statistics, RESEARCH funding, THEMATIC analysis, DATA analysis software, EDUCATIONAL outcomes
Abstract

Background: In the Netherlands, general practitioners (GPs) play a key role in provider-initiated HIV testing, but opportunities for timely diagnosis are regularly missed. We implemented an educational intervention to improve HIV testing by GPs from 2015 to 2020, and observed a 7% increase in testing in an evaluation using laboratory data. The objective for the current study was to gain a deeper understanding of whether and how practices and perceptions of GPs' HIV/sexually transmitted infection (STI) testing behaviour changed following the intervention. Methods: We performed a mixed-methods study using questionnaires and semi-structured interviews to assess self-reported changes in HIV/STI testing by participating GPs. Questionnaires were completed by participants at the end of the final educational sessions from 2017 through 2020, and participating GPs were interviewed from January through March 2020. Questionnaire data were analysed descriptively, and open question responses were categorised thematically. Interview data were analysed following thematic analysis methods. Results: In total, 101/103 participants completed questionnaires. Of 65 participants that were included in analyses on the self-reported effect of the programme, forty-seven (72%) reported it had changed their HIV/STI testing, including improved STI consultations, adherence to the STI consultation guideline, more proactive HIV testing, and more extragenital STI testing. Patients' risk factors, patients' requests and costs were most important in selecting STI tests ordered. Eight participants were interviewed and 15 themes on improved testing were identified, including improved HIV risk-assessment, more proactive testing for HIV/STI, more focus on HIV indicator conditions and extragenital STI testing, and tools to address HIV during consultations. However, several persistent barriers for optimal HIV/STI testing by GPs were identified, including HIV-related stigma and low perceived risk. Conclusions: Most GPs reported improved HIV/STI knowledge, attitude and testing, but there was a discrepancy between reported changes in HIV testing and observed increases using laboratory data. Our findings highlight challenges in implementation of effective interventions, and in their evaluation. Lessons learned from this intervention may inform follow-up initiatives to keep GPs actively engaged in HIV testing and care, on our way to zero new HIV infections. [ABSTRACT FROM AUTHOR]

Published
2023
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2. Promoting HIV indicator condition-guided testing in hospital settings (PROTEST 2.0): study protocol for a multicentre interventional study

Author

Bogers, Saskia J., Schim van der Loeff, Maarten F., Davidovich, Udi, Boyd, Anders, van der Valk, Marc, Brinkman, Kees, de Bree, Godelieve J., Reiss, Peter, van Bergen, Jan E. A. M., Geerlings, Suzanne E., van Bergen, J. E. A. M., Brokx, P., Deug, F., Heidenrijk, M., Prins, M., Reiss, P., van der Valk, M., de Bree, G. J., Geerlings, S. E., Hoornenborg, E., Achterbergh, R. C. A., Ananworanich, J., van de Beek, D., Brinkman, N., de Bruin, M., Bruisten, S., Coyer, L., Dijkstra, M., Geijtenbeek, T. B. H., Godfried, M. H., Goorhuis, A., Hankins, C. A., Hogewoning, A., Hovius, J. W., de Jong, K., Kootstra, N. A., Lauw, F., van der Meer, J. T., Mulder, B. J., Nellen, F. J., Peters, E., van der Poll, T., van Rooijen, M. S., Sonder, G. J., de Vries, H. J., van Vugt, M., Wiersinga, W. J., Wit, F. W., Zantkuijl, P., Graduate School, Vascular Medicine, AII - Infectious diseases, Infectious diseases, APH - Aging & Later Life, APH - Global Health, Global Health, General practice, APH - Methodology, APH - Quality of Care, Medical Microbiology and Infection Prevention, Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, Experimental Immunology, Center of Experimental and Molecular Medicine, Dermatology, APH - Digital Health, APH - Personalized Medicine, Sociale Psychologie (Psychologie, FMG), Psychology Other Research (FMG), Stichting Aidsfonds, Virology, Medical Microbiology & Infectious Diseases, and Internal Medicine

Subjects
medicine.medical_specialty, Pediatrics, Tuberculosis, Multifaceted intervention, HIV Positivity, HIV Transmission Elimination AMsterdam (H-TEAM) Consortium, HIV Infections, Infectious and parasitic diseases, RC109-216, Indicator condition, Healthcare quality improvement, Microbiology, 03 medical and health sciences, Study Protocol, 0302 clinical medicine, Medical microbiology, SDG 3 - Good Health and Well-being, 1108 Medical Microbiology, Intervention (counseling), medicine, Clinical endpoint, Prevalence, Humans, Mass Screening, 030212 general & internal medicine, Netherlands, 030505 public health, business.industry, Patient Selection, virus diseases, 1103 Clinical Sciences, Hepatitis B, Vulvar cancer, medicine.disease, Hospitals, HIV testing, Infectious Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Implementation, Tropical medicine, 0305 other medical science, business, 0605 Microbiology
Abstract

Background Late presentation remains a key barrier towards controlling the HIV epidemic. Indicator conditions (ICs) are those that are AIDS-defining, associated with a prevalence of undiagnosed HIV > 0.1%, or whose clinical management would be impeded if an HIV infection were undiagnosed. IC-guided HIV testing is an effective strategy in identifying undiagnosed HIV, but opportunities for earlier HIV diagnosis through IC-guided testing are being missed. We present a protocol for an interventional study to improve awareness of IC-guided testing and increase HIV testing in patients presenting with ICs in a hospital setting. Methods We designed a multicentre interventional study to be implemented at five hospitals in the region of Amsterdam, the Netherlands. Seven ICs were selected for which HIV test ratios (proportion of patients with an IC tested for HIV) will be measured: tuberculosis, cervical/vulvar cancer or high-grade cervical/vulvar dysplasia, malignant lymphoma, hepatitis B and C, and peripheral neuropathy. Prior to the intervention, a baseline assessment of HIV test ratios across ICs will be performed in eligible patients (IC diagnosed January 2015 through May 2020, ≥18 years, not known HIV positive) and an assessment of barriers and facilitators for HIV testing amongst relevant specialties will be conducted using qualitative (interviews) and quantitative methods (questionnaires). The intervention phase will consist of an educational intervention, including presentation of baseline results as competitive graphical audit and feedback combined with discussion on implementation and opportunities for improvement. The effect of the intervention will be assessed by comparing HIV test ratios of the pre-intervention and post-intervention periods. The primary endpoint is the HIV test ratio within ±3 months of IC diagnosis. Secondary endpoints are the HIV test ratio within ±6 months of diagnosis, ratio ever tested for HIV, HIV positivity percentage, proportion of late presenters and proportion with known HIV status prior to initiating treatment for their IC. Discussion This protocol presents a strategy aimed at increasing awareness of the benefits of IC-guided testing and increasing HIV testing in patients presenting with ICs in hospital settings to identify undiagnosed HIV in Amsterdam, the Netherlands. Trial registration Dutch trial registry: NL7521. Registered 14 February 2019.

Published
2021

3. Is reaching 90-90-90 enough to end AIDS? Lessons from Amsterdam

Author

Bree, G.J. de, Sighem, A. van, Zuilhof, W., Bergen, J.E.A.M. van, Prins, M., Heidenrijk, M., Valk, M. van der, Brokx, P., Reiss, P., Deug, F., Davidovich, U., Geerlings, S.E., Hoornenborg, E., Oomen, A., Bruinderink, M.L.G., Schat, N., Achterbergh, R.C.A., Agtmael, M. van, Ananworanich, J., Beek, D. van de, Berk, G.E.L. van den, Bezemer, D., Bijnen, A. van, Blok, W.L., Bogers, S., Bomers, M., Boucher, C.A.B., Brokking, W., Burger, D., Brinkman, K., Brinkman, N., Bruin, M. de, Bruisten, S., Coyer, L., Crevel, R. van, Daans, C.G., Derckx, T., Dijkstra, M., Duijnhoven, Y.T. van, Eeden, A. van, Elsenburg, L., Elshout, M.A.M. van den, Ester, C., Ersan, E., Felipa, P.E.V., Geijtenbeek, T.B.H., Gool, J. van, Goorhuis, A., Groot, M., Hankins, C.A., Heijnen, A., Hillebregt, M.M.J., Hogewoning, A., Hommenga, M., Hovius, J.W., Janssen, Y., Jong, K. de, Jongen, V., Kootstra, N.A., Koup, R.A., Kroon, F.P., Laar, T.J.W. van de, Lauw, F., Leeuwen, M.M. van, Lettinga, K., Linde, I., Loomans, D.S.E., Mouhebati, T., Mulder, B.J., Mulder, J., Nellen, F.J., Nijsters, A., Nobel, H., Oostvogel, P., Coul, E.L.M. op de, Peters, E., Peters, I.S., Poll, T. van der, Ratmann, O., Rokx, C., Rooijen, M.S. van, Loeff, M.F.S. van der, Schoute, W.E.M., Sonder, G.J., Veenstra, J., Verbon, A., Vries, H.J. de, Vrouenraets, S., Vugt, M. van, Wiersinga, W.J., Wit, F.W., Zaheri, S., Zantkuijl, P., Zelm, M.C. van, Zakowicz, A., Zimmermann, H.M.L., HIV Transmission Elimination, Virology, and Internal Medicine

Subjects
0301 basic medicine, medicine.medical_specialty, Anti-HIV Agents, Immunology, Human immunodeficiency virus (HIV), MEDLINE, Hiv testing, medicine.disease_cause, epidemic, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, Virology, Environmental health, Medicine, Humans, 030212 general & internal medicine, Amsterdam, Hiv transmission, Netherlands, Acquired Immunodeficiency Syndrome, Oncology (nursing), business.industry, Transmission (medicine), Public health, virus diseases, HIV, Hematology, Integrated approach, medicine.disease, 030104 developmental biology, Infectious Diseases, Oncology, business
Abstract

Purpose of review Although cities present opportunities for infectious pathogens such as HIV to spread, public health infrastructure within these cities also provides opportunities to design effective approaches to eliminate transmission of these pathogens. The HIV Transmission Elimination AMsterdam (H-TEAM) Initiative, a consortium of relevant stakeholders involved in HIV prevention and care, designed an integrated approach to curb the HIV epidemic in Amsterdam, including providing preexposure prophylaxis (PrEP), increasing awareness of acute HIV infection, offering same-day test and treat, and improving indicator disease-driven HIV testing. Recent findings In 2013, approximately 230 people in Amsterdam were newly diagnosed with HIV, largely belonging to one of two key affected populations, namely MSM and people with a migration background. Since the start of H-TEAM in 2014, a decrease in new diagnoses was observed (130 in 2017), with an increasing proportion of MSM who had been diagnosed with a recent infection. Summary The H-TEAM shows that a city-based concerted effort is feasible. However, major challenges remain, such as reducing the number of late HIV diagnoses, and identifying and providing appropriate services to a diminishing group of individuals who are likely the source of transmission.

Published
2019

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