{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:19:36Z","timestamp":1787807976954,"version":"build-2784847793"},"reference-count":10,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Background<\/jats:title>\n Local HIV testing policy is based on clinician assessment of risk factors and HIV indicator conditions, with patient consent required before testing. This project aimed to increase HIV testing among hospital inpatients with community-acquired pneumonia, reduce reliance on clinician judgement, and promote more equitable testing practices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Adult hospital inpatients (aged \u226516 years) with community-acquired pneumonia discharged between July and November 2024 were included, irrespective of specialty, and assessed for evidence of HIV testing within the preceding 12 months. Weekly HIV testing rates were monitored throughout the project as a series of quality improvement measures were introduced. These included a hospital grand round presentation, safety briefing, targeted education, guideline updates, an electronic community-acquired pneumonia\u2013HIV order set, and educational posters.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 894 hospital inpatients with community-acquired pneumonia were included, of whom 148 (17%) were tested for HIV. Testing rates increased from 4% at baseline to 29% following successive interventions and rose by 3.6% per week over the study period (IRR 1.036, 95% CI 1.01\u20131.063;\n p<\/jats:italic>\n = 0.005). Pathway-embedded interventions produced more sustained improvements than education alone. Male patients were more likely to undergo HIV testing than female patients (19.8% vs 13.0%; \u03c7\n 2<\/jats:sup>\n (1) = 7.67,\n p<\/jats:italic>\n = 0.006), with the greatest disparity observed among patients aged 50\u201369\u00a0years (35.3% vs 8.6%; \u03c7\n 2<\/jats:sup>\n (1) = 21.7,\n p<\/jats:italic>\n < 0.001). Testing rates also differed significantly by age group (\n p<\/jats:italic>\n < 0.001), being highest among patients aged 30\u201349\u00a0years and lowest among those aged \u226570\u00a0years. All 148 HIV tests were negative.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n HIV testing improved significantly following sequential interventions, with pathway-embedded system changes producing more sustainable improvements than education alone. Persistent age- and sex-related disparities suggest clinician risk perception continues to influence HIV testing practices. Low-prevalence settings should consider electronic testing pathways, automated prompts, and the feasibility of opt-out testing approaches.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/09564624261470104","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:56:04Z","timestamp":1783925764000},"page":"1095-1099","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving HIV testing rates in patients with community-acquired pneumonia in a low HIV prevalence region"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8210-4702","authenticated-orcid":false,"given":"Richard","family":"Ford","sequence":"first","affiliation":[{"name":"Buckinghamshire Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-9488","authenticated-orcid":false,"given":"Heewon","family":"Yoon","sequence":"additional","affiliation":[{"name":"Buckinghamshire Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0995-319X","authenticated-orcid":false,"given":"Angela C","family":"Bailey","sequence":"additional","affiliation":[{"name":"Buckinghamshire Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Global AIDS strategy 2021\u20132026: end inequalities","author":"UNAIDS","year":"2021","unstructured":"UNAIDS. Global AIDS strategy 2021\u20132026: end inequalities. End AIDS, 2021."},{"key":"e_1_3_5_3_2","volume-title":"HIV surveillance in England: 2023 report","author":"UK Health Security Agency","year":"2023","unstructured":"UK Health Security Agency. HIV surveillance in England: 2023 report. UKHSA, 2023."},{"key":"e_1_3_5_4_2","volume-title":"UK national guidelines for HIV testing 2020","author":"British HIV Association, British Association for Sexual Health and HIV, British Infection Association","year":"2020","unstructured":"British HIV Association, British Association for Sexual Health and HIV, British Infection Association. UK national guidelines for HIV testing 2020. BHIVA, 2020."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(16)30020-2"},{"key":"e_1_3_5_6_2","volume-title":"HIV testing (NG60)","author":"National Institute for Health and Care Excellence","year":"2016","unstructured":"National Institute for Health and Care Excellence. HIV testing (NG60). NICE, 2016. (updated 2021)."},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0052845"},{"key":"e_1_3_5_8_2","volume-title":"Towards elimination of HIV transmission, AIDS and HIV-Related deaths in England: 2022 report","author":"UK Health Security Agency","year":"2022","unstructured":"UK Health Security Agency. Towards elimination of HIV transmission, AIDS and HIV-Related deaths in England: 2022 report. UKHSA, 2022."},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2019-010411"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1356430"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0140845"}],"container-title":["International Journal of STD & AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261470104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261470104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261470104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:41:20Z","timestamp":1787805680000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261470104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,12]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/09564624261470104"],"URL":"https:\/\/doi.org\/10.1177\/09564624261470104","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,12]]}}}