Missed opportunities for HIV testing in hospitalised adults in türkiye: ındicator conditions and testing coverage in a national multicentre point-prevalence survey (HIV-ICs-TR)

To quantify the prevalence of HIV testing indications among hospitalised adults in Türkiye, assess HIV testing coverage when clinically indicated, and identify missed diagnostic opportunities in a national multicentre point-prevalence survey. We conducted a national multicentre cross-sectional point-prevalence survey across tertiary referral hospitals from all seven geographical regions of Türkiye. Adult inpatients present at 08:00 on a predefined index day were assessed for predefined HIV testing indications, including AIDS-defining conditions, indicator conditions associated with an expected undiagnosed HIV prevalence ≥ 0.1%, and conditions in which unrecognised HIV could substantially affect clinical management. Among 3,425 hospitalised adults without known HIV infection, 699 (20.4%) had at least one documented HIV testing indication. HIV testing was requested by the primary clinical team in 424/699 patients (60.7%). Testing was lowest in patients with indicator conditions associated with an expected undiagnosed HIV prevalence ≥ 0.1%, and these conditions were independently associated with higher odds of non-performance of HIV testing by the primary clinical team than AIDS-defining conditions (corresponding adjusted odds ratio [aOR] 3.05, 95% confidence interval [CI] 1.67-5.81). In centres with a specialised HIV outpatient clinic, the odds of non-performance of HIV testing by the primary clinical team were independently lower among patients with an appropriate testing indication (corresponding aOR 0.64, 95% CI 0.43-0.95). Following study-team facilitation, overall testing coverage increased to 677/699 (96.9%). Three reactive screening results were identified, including two confirmed new HIV diagnoses. HIV testing indications were common among hospitalised adults in Türkiye, but non-performance of HIV testing by the primary clinical team remained frequent, particularly for non-AIDS indicator conditions. Strengthening indicator-condition-guided testing through structured clinical pathways and institutional HIV expertise may reduce non-performance and support earlier HIV diagnosis.

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Publication Details

Journal
Scientific Reports
Published
2026-05-30
DOI
https://doi.org/10.1038/s41598-026-54294-6
Primary Topic
HIV/AIDS Research and Interventions
Type
article
Field-Weighted Citation Impact
0.00

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article

Missed opportunities for HIV testing in hospitalised adults in türkiye: ındicator conditions and testing coverage in a national multicentre point-prevalence survey (HIV-ICs-TR)

Damla Ertürk, Buket Ertürk Şengel, Yeliz Çiçek, Süheyla Kömür et al.
Scientific Reports
HIV/AIDS Research and Interventions
article

Missed opportunities for HIV testing in hospitalised adults in türkiye: ındicator conditions and testing coverage in a national multicentre point-prevalence survey (HIV-ICs-TR)

Damla Ertürk, Buket Ertürk Şengel, Yeliz Çiçek, Süheyla Kömür, Gürdal Yılmaz, Seyit Ali Büyüktuna, Caner Öksüz, Tuba İlgar, Ömer Faruk Yardımcı, Kemalettin Özden, Yeşim Taşova, Aybegüm Özşahin, Derya Kaya, Cansu Tol, Mustafa Kemal Çelen, Gülter Öncü Kurutaş, Handan Alay, Fatma Kesmez Can, Tajdin İrdem, Zülal Peri Yoldaş Aslanoğlu, Ahmet Turan Koç, Rıdvan Karaarslan, HANİFE NUR KARAKOÇ PARLAYAN, Adem Kaya, Esra İrem Dağcı, Maşite Nur Özdemir, Oğuzhan Acet, Duygu Aran Seçkin, Kenan Beşbaş, Galip Erdoğan, Hüsnü Pullukçu, Meltem Ceylan, İlknur Esen Yıldız, Esma Demir Kalyoncu, Mehmet Buğra Özkara, Sümeyra Demir, Diana Zakaradze, Betül Seçen Gülçek, Ayşe Albayrak, Sudem Mahmutoğlu-Çolak, Kübra Okul, Betul Ocak, Gökçe Melis Çolak
article en

Abstract

To quantify the prevalence of HIV testing indications among hospitalised adults in Türkiye, assess HIV testing coverage when clinically indicated, and identify missed diagnostic opportunities in a national multicentre point-prevalence survey. We conducted a national multicentre cross-sectional point-prevalence survey across tertiary referral hospitals from all seven geographical regions of Türkiye. Adult inpatients present at 08:00 on a predefined index day were assessed for predefined HIV testing indications, including AIDS-defining conditions, indicator conditions associated with an expected undiagnosed HIV prevalence ≥ 0.1%, and conditions in which unrecognised HIV could substantially affect clinical management. Among 3,425 hospitalised adults without known HIV infection, 699 (20.4%) had at least one documented HIV testing indication. HIV testing was requested by the primary clinical team in 424/699 patients (60.7%). Testing was lowest in patients with indicator conditions associated with an expected undiagnosed HIV prevalence ≥ 0.1%, and these conditions were independently associated with higher odds of non-performance of HIV testing by the primary clinical team than AIDS-defining conditions (corresponding adjusted odds ratio [aOR] 3.05, 95% confidence interval [CI] 1.67-5.81). In centres with a specialised HIV outpatient clinic, the odds of non-performance of HIV testing by the primary clinical team were independently lower among patients with an appropriate testing indication (corresponding aOR 0.64, 95% CI 0.43-0.95). Following study-team facilitation, overall testing coverage increased to 677/699 (96.9%). Three reactive screening results were identified, including two confirmed new HIV diagnoses. HIV testing indications were common among hospitalised adults in Türkiye, but non-performance of HIV testing by the primary clinical team remained frequent, particularly for non-AIDS indicator conditions. Strengthening indicator-condition-guided testing through structured clinical pathways and institutional HIV expertise may reduce non-performance and support earlier HIV diagnosis.

Scientific Reports
Dicle University (TR), Sivas Cumhuriyet Üniversitesi (TR), Recep Tayyip Erdoğan University (TR), Karadeniz Technical University (TR), Istanbul Medipol University (TR), Ege University (TR), Cukurova University (TR), Atatürk University (TR), Marmara University (TR)
Çukurova Üniversitesi, Sivas Cumhuriyet Üniversitesi, Ege Üniversitesi, Karadeniz Teknik Üniversitesi, Atatürk Üniversitesi, Dicle Üniversitesi, Marmara Üniversitesi
Good health and well-being
Openalex Percentile: Top 5%
HIV/AIDS Research and Interventions
DOIOpen Access PDFOpenAlex
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