Metrics details. Access to HIV testing is crucial for detection, linkage to treatment, and prevention. In less urbanised areas, reliance on general practitioners GPs for HIV testing is probable, as sexual health centres SHC are mostly located within urbanised areas.
Limited insight into individuals undergoing HIV testing stems from sparse standard registration of demographics at GPs. The overall proportion HIV tested was 1. Large differences in HIV testing rate 1. In general, population groups that are relatively often tested are also the groups with most diagnoses and highest incidence e. The overall incidence was A relatively high incidence often follows relatively high testing rates.
Strategies include additional targeted testing, via for example SHC branch locations and outreach activities. Peer Review reports. Larger distance to and limited availability of testing sites are associated with lower test rates for a sexually transmitted infection STI including HIV [ 1 , 2 , 3 ]. Other barriers are concerns about privacy, confidentiality, and stigma [ 4 ]. These barriers are possibly greater for non-specialised sexual healthcare settings and people living in low urbanised areas [ 4 , 5 ].
Public sexual health centres SHCs are often located in urban areas. As a result, STI testing in suburban and rural areas likely depends more on other healthcare providers, like general practitioners GPs. Approximately two-thirds of STI consultations take place in primary care and the rest at the SHC; a minority uses other settings such as private self- care [ 6 , 7 ].
An HIV test at the GP may incur costs as part of the compulsory financial contribution for health insurance. Accommodating all appointment requests poses a challenge for SHCs, even for individuals belonging to key populations. These percentages represent the initial provider where HIV diagnosis occurs. Signs or symptoms are likely to underlie HIV testing in hospitals after referral by a GP, who acts as gatekeeper to secondary care in the Netherlands. There are approximately 24, people with HIV, of whom around 1, remain undiagnosed [ 12 ].
