Monitoring HIV-indicator condition guided HIV testing in Estonia

OBJECTIVES: The aim of the study was to assess indicator condition (IC) guided HIV testing in Estonia from 2012-2015. METHODS: We used Estonian Health Insurance Fund (EHIF) data. EHIF is the core purchaser of health care services in Estonia, covering health care costs for insured people (94% of the total population). After health care services' provision, the provider sends an invoice to EHIF, which includes patient information (e.g. age, gender, diagnoses based on ICD-10) and services provided (e.g. what tests were performed). RESULTS: Among the ICs analysed, the highest proportion of patients tested was among those presenting with infectious mononucleosis-like illness (27-33% of patients) and viral hepatitis (28-32%), the lowest proportion of patients tested was among those presenting with herpes zoster (4-5%) and pneumonia (4-8%). Women were tested somewhat less than men, especially in cases of sexually transmitted infections (9-13% and 18-21%, respectively). CONCLUSIONS: Our data shows that IC-guided HIV testing rates are low in Estonia. Therefore, it is critical to follow Estonian HIV testing guidelines, which recommend IC-guided testing. In general, health insurance data can be used to monitor IC-guided HIV testing.