{
  "abstract": "Background In Italy, the national HIV surveillance system reports newly diagnosed HIV cases but does not collect data on the total number of HIV tests performed. Therefore, trends in new diagnoses cannot be interpreted as related to testing activity. Information on the number of tests provides the denominator needed to contextualize incidence data and to better understand changes over time. Monitoring testing volumes can support public health planning by identifying differences in service provision and potential reductions or gaps in access to testing. The PRONTI project (Project on the Number of HIV Tests Performed in Italy), funded by the Italian Ministry of Health, aims to evaluate the availability and coverage of HIV testing by analyzing outpatient specialist administrative data. This study presents preliminary findings on the number of HIV tests performed in Italy between 2018 and 2023.Materials and Methods A retrospective analysis was conducted on HIV tests performed by the National Health Service between 2018 and 2023 among people aged ≥18 years living in Italy. Tests were identified using the national reimbursement code for first-level HIV testing, corresponding to the fourth-generation combined assay detecting anti-HIV-1/2 antibodies and HIV-1 p24 antigen. Data were extracted from national administrative healthcare databases that exclude screening for blood donations. The total number of screening tests was calculated for each year. Annual screening rates were computed as the number of tests performed divided by the resident adult population, both at the national level and by region.Results Between 2018 and 2023, the annual number of first-level HIV tests performed in Italy ranged from a minimum of 889,972 in 2020 to a maximum of 1,133,377 in 2018. Overall, roughly one million screening tests were performed annually. Testing volumes remained relatively stable over time, with a marked reduction in 2020, followed by a progressive increase. When standardized to the adult resident population, the average annual screening rate was 2.1%, ranging from 1.8% in 2020 to 2.3% in 2018. In 2023, the screening rate was 2.2%. Figure 1 reports the mean screening rates by region. Rates were generally higher in Northern and Central Italy than in Southern Italy and the Islands.Conclusions The reduction in the total number of tests observed in 2020 is likely attributable to the COVID-19 pandemic and the associated decrease in access to outpatient services. Preliminary findings indicate a North–South gradient in testing rates, suggesting potential disparities in access to HIV testing services across regions. Further analyses will include confirmatory and monitoring tests (immunoblot and HIV-RNA) and region-by-region comparisons between screening tests, confirmatory tests, and newly diagnosed cases. Establishing the denominator of testing activity is essential for better interpretation of national HIV surveillance data and to inform public health action.Abstract SC26 Figure 1HIV screening rate (number of tests/population x 100) by region of residence, 2018-2023",
  "authors": [
    {
      "affiliations": [
        "University of Pisa, Pisa, Italy"
      ],
      "name": "G Cruschelli"
    },
    {
      "affiliations": [
        "Ministry of Health, Rome, Italy"
      ],
      "name": "A Caraglia"
    },
    {
      "affiliations": [
        "Policlinic of Bari, Bari, Italy"
      ],
      "name": "F Centrone"
    },
    {
      "affiliations": [
        "University of Bari, Bari, Italy"
      ],
      "name": "M Chironna"
    },
    {
      "affiliations": [
        "Mario Mieli, LGBTQIA+ Culture Center, Rome, Italy"
      ],
      "name": "M Farinella"
    },
    {
      "affiliations": [
        "Independent researcher, Rome, Italy"
      ],
      "name": "C Galli"
    },
    {
      "affiliations": [
        "University of Pisa, Pisa, Italy"
      ],
      "name": "S Moriconi"
    },
    {
      "affiliations": [
        "University of Bari, Bari, Italy"
      ],
      "name": "VA Orlando"
    },
    {
      "affiliations": [
        "Piedmont Regional Service for the Epidemiology of Infectious Diseases (SeREMI), Alessandria, Italy"
      ],
      "name": "C Pasqualini"
    },
    {
      "affiliations": [
        "Tuscany Regional Health Agency, Florence, Italy"
      ],
      "name": "M Puglia"
    },
    {
      "affiliations": [
        "Italian National Institute of Health, Rome, Italy"
      ],
      "name": "L Pugliese"
    },
    {
      "affiliations": [
        "Caritas Ambrosiana, Milano, Italy"
      ],
      "name": "L Rancilio"
    },
    {
      "affiliations": [
        "Italian National Institute of Health, Rome, Italy"
      ],
      "name": "V Regine"
    },
    {
      "affiliations": [
        "Tuscany Regional Health Agency, Florence, Italy"
      ],
      "name": "F Voller"
    },
    {
      "affiliations": [
        "University of Pisa, Pisa, Italy"
      ],
      "name": "L Tavoschi"
    },
    {
      "affiliations": [
        "Italian National Institute of Health, Rome, Italy"
      ],
      "name": "B Suligoi"
    }
  ],
  "title": "SC26 Searching for the denominator: preliminary findings from PRONTI project",
  "uid": "a86ffdd5-88e0-5c60-93e5-ae7cd2fd9240"
}