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London hospitals to offer routine HIV tests to A&E patients

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  1. Jock S. Trap 8 Jun 2011, 1:37pm

    Excellent.
    Fully support this.
    It has to be better to offer this and possibly save lives.

  2. HelenWilson 8 Jun 2011, 1:46pm

    I would have no problem with all blood tests being screened for HIV as a matter of routine. We have too many people walking around unaware they are infected with this so infecting others.

    1. Jock S. Trap 8 Jun 2011, 2:03pm

      Exactly.

      1. I agree too :)

    2. Don’t agree helen. Stupid idea. Forcing people to be tested for anything is wrong in a free society. It’s called choice.

      1. If you unknowingly infect somebody with HIV you infringe on their life in a way that impairs their freedom to make any choice. I reserve the right not to be HIV +VE, and a step towards that is making everybody in the world aware of their HIV status.

      2. Jock S. Trap 9 Jun 2011, 9:14am

        What about other people’s choice not to get HIV?
        There are too many ignorant people who take risks while sleeping around and refuse to get tested and pass on STDs/HIV.
        Alcohol is usually blamed but is it really an excuse to give someone an incurable illness?
        They refuse to take the blame.
        So a forced hand has to do something and this is the better option.
        Personally I’d prefer if they did it as standard on every patient, that way testing wouldn’t be discriminatory.

      3. No-one is being forced to get a test.

        They are being offered a chance to get a test if they want as a matter of routine.

        Which is called a choice.
        which you apparently support.

        So what’s the issue?

        1. Jock S. Trap 9 Jun 2011, 4:25pm

          Indeed though personalIy I do feel that this testing should be mandatory.

          1. @Jock S Trap

            You can not make anyone have a particular test unless they pose a significant threat to the population e.g. Ebola, West Nile Virus etc

            Asking clinicians to forceably test people who have mental capacity to make a decision would be changing the relationship between clinician and patient and as a clincian (and patient) I would not be happy with such a change in the relationship

      4. @Eddy

        First thing is that no one is being forced to be tested – there is always patient choice – this is a routine test that is now being offered in some A&E departments that previously would not have been – it is for the patient to decide if they wish to take part in the testing or not – if they do not want to then the hospital can not ethically continue with the testing

        That said, on a wider morality issue I can not see why any reasonable person would not be prepared to be tested provided they have good support whatever the outcome of the testing

  3. Great idea, they should introduce it to all hospitals.

  4. I support this in principle.

    But can someone confirm whether or not a postive diagnosis will be anonymous ie if for example I fall and break my ankle; go to A+E for treatment and I get offered and accept a HIV test and i agree. If my test result is positive then who will the hospital tell apart from me.

    Will this test be reported to life insurance companies; family doctors etc.

    Like I said I agree with the idea in principle but I think that the hospitals have to clarify exactly the practical consequences of agreeing to this.

    1. Jock S. Trap 8 Jun 2011, 2:32pm

      No.
      The information is kept by that hospital for the hospital for your treatment.
      If your move HIV treatment they are only allowed to write a report to your new hospital they are not allowed your records.
      It’s quite different to changing GP’s.
      Confidentiality is stricter.
      They recommend you tell your GP but that is your choice.
      They are only allowed to disclose with your consent.

      1. I would still have concerns, an Insurance company can seriously load or even refuse you if they have access to a record that you’ve even had a HIV test.

        1. …..still, good idea in principle, once confidentiality is respected.

          1. All blood tests taken are routinely screened for a number of conditions/stroke illnesses, including HIV. This is done anonymously (ie nobody knows where the blood sample has come from) and this is how they can identify that a certain number of people are HIV+ but undiagnosed. It is only when you give consent to having a HIV test done on your blood that it becomes confidential to you and to the hospital. However, consent does have to be given.

        2. Jock S. Trap 9 Jun 2011, 9:19am

          I understand your concerns Will, I think most people would have them.
          I have been HIV now about 15 years, meds 3 years, changed hospital twice and never had a problem.
          My only concern has been changing hospitals because of the lack of sharing my information.
          It’s a good thing in general but not when you need the new hospital to know all the facts.

          1. I have also recently had to change hospitals. However, I did so because I wanted to follow my Specialist. I was lucky – she managed to sneak out most of my files and what she couldn’t take we together managed to remember most of. Not an ideal situation but understandable!

          2. Jock S. Trap 9 Jun 2011, 4:27pm

            Roland
            But thats the best way to do it esp you have a specialist your comfortable with.

        3. @Will

          I understand why you would have concerns given historical reporting of issues with GPs, dentists and insurance companies etc.

          However, the reality is that there is a very strict guideline on how disclosure of HIV status can be made even between clinicians.

          As a clinician, I will only disclose HIV status (even to other clinicians) if the patient consents AND it is likely to be relevant to the presenting issue that I am discussing with the other clinician OR the patient lacks capacity AND it is likely to be relevant to the issue I wish to talk to the other clinician about.

      2. Longterm PWA 9 Jun 2011, 6:55pm

        this is the case in principle, but many hospitals will actually inform your general practictioner until and unless you do something called a ’93c9′ opt-out form, otherwise they will assume they have ‘implied consent’, I know a couple of occasions where this has happened and the person concerned now can’t get life insurance and a house sale fell through. I know you’re an advocate of testing, but it’s a double edged sword and not to be taken likely, you get a positive test, the word spread and then the newly positive person will be ignored and alienated by the testing organisation, and any disclosure will be covered by a meaningless ‘apology’ and no accountability to the testing facility, it just isn’t that simple in the real world, HIV is a complex problem and won’t be solved by apparently simple solutions, it will cause many more problems that it solves

        1. Jock S. Trap 10 Jun 2011, 8:39am

          It does cause some problems which are unnecessary because these things like life insurance haven’t changed with the times.
          They used to deny because HIV was considered a death sentence but it isn’t any longer.
          It is totally managerable and the government and these firms should seek to change this discriminatory stand.

          1. There already is an acceptance by the British Insurance industry that HIV is not a death sentence and a condition that has no more significant implications than something such as diabetes.

      3. Longterm PWA 1 Jul 2011, 6:16pm

        I do wish you’d actually know what the hell you’re talking about before giving out such badly informed advice as if it were gospel, the hospital WILL report this to your GP unless you specifically request they don’t AND GET IT IN WRITING BEFOREHAND, once on your GP’s records, any requests for a health summary will include the results of any STD tests and results, this will include life insurance, job-related requests and other miscellaneous enquiries. your GP is duty bound to so inform them or they could be in line for backlash in the future if they don’t. Wise up and take off those rose coloured-tht-sponsored specs and get real

  5. Staircase2 8 Jun 2011, 6:19pm

    My concern is about the level of counselling that people may have before their blood is taken for testing and therefore how prepared they may be for a positive result should that occur

    1. Staircase2: You are right and I agree. My Husband and I went for several tests when we got together, and the counseling we were given before each was explicit.

      They even discussed if the test was positive, would we be prepared for that and if they should keep it secret.

      Fortunately, we were both negative (we were careful bunnies and still are), but I think it is better to know than not. I have heard from a friend in the TA that they encourage them to give blood so that they are routinely screened for infections, this is no different.

      As regards the confidentiality of the outcome with respect to insurance companies / future employers and the like. None of their business. Anyone who gives away my medical records without my consent is letting themselves open to a whole can of whupass…

    2. Jock S. Trap 9 Jun 2011, 9:30am

      I understand what your saying but for most, myself included, no amount of counselling before prepares you for the words “I’m afraid the tests came back positive. I’m Very sorry but you do have HIV”.
      It leaves you completely numb.
      Hopefully it’s the level of help afterwards that helps, though not for all.
      I accepted it very quickly as I didn’t really see what choice I had.
      Telling everyone straight away was the biggest help in me coming to terms.
      You may get some hurtful reactions but if telling the people you love most is the hardest part, it’s best to get it over with as qucily as possible.

    3. I think the counselling people receive before a HIV test is just a formality and never too serious.

      Every time I get a test I say to the counsellor ‘I’ve been herer before. Can’t we just get on with it please.’

      If you are HIV+ then 3 minutes with a counsellor before the test is not going to be of any use.

      1. I had no pre or post test counselling. I was so unwell and had been for such a long time that when the HIV test was suggested that I was willing to undergo any test that would help to find out what was going on. After I went straight on to medication and brilliant medical care, including a gay district nurse who came to my house almost daily basis on his bike, wearing his leathers. Not sure what the neighbours thought! Who cares….

  6. Hospitals do inform Gps without your consent . if you see a Doctor in the hospital – non HIV related – the chances are they will by default tell your Gp – they will mention the diagnosis in the clinic letter – believe me I know.

    1. Then you have grounds for a formal complaint as it should be noted in your hospital notes whether or not you are happy for that particular information to be disclosed to your GP or not

      1. I see that you state you are a clinician? Can I ask in what field?

        1. Primary and emergency care

  7. As stated by a previous person on here you will probably receive an apology – a bit late when the damage is done! There is too much cross over of patient’s diagnosis and mistakes happen because of this “universal” Gp must know everything. I believe people are covered by the VD Act of 1974 regarding Confidentiality, etc, but for some reason HIV is deemed different.

    For the record the hospital in question is Brighton.

    1. Would be covered by Data Protection Act, Health Records Act and other assorted clauses from various Health Acts

      An apology certainly should be forthcoming, but so should some retraining for clinicians who were shoddy in their practices – if not discipline or prosecution

      GP should know a lot about us as patients – but does not need to know HIV status necessarily – it is of benefit, but there may be good reasons why a particular patient may not wish this to occur – and then it should not. That is why consent and treatment, investigations and disclosure of information should be done on an informed basis. The clinicians involved should recognise the decisions made by the patient (provided the patient has mental capacity) and comply with them. That said, clinicians are human and do make mistakes – but these should be rare and should be dealt with.

      1. I take your points but I believe it is not just an isolated case. Unless you make it clear in a consultation regardless if you have already stated you do not wish your Gp to know, the chances are that another Consultant in a different area to HIV will cc a letter to the Gp and this is how Gp’s by default are informed of a patient’s HIV. You basically have to state to every Doctor you see in a hospital that YOU DO NOT WISH YOUR GP TO KNOW. If you have an email I would be happy to converse through that rather than public domain.

        1. One of my emails is singboyne at yahoo dot co dot uk

          1. Longterm PWA 26 Jun 2011, 11:48am

            Ady has the right of it here, medical professionals (and what a misnomer THAT is) will do whatever they like and justify it after the damage has been done as ‘being in the public interest’ or any number of other reasons not to be disciplined or held accountable, HIV ‘organisations’ THT, lighthouse et al WILL NOT HELP or ‘get involved’ as it would upset their own applecarts (or bandwagons) and highlight the complete failure of their stated strategies of STI prevention. for which they are wasting massive quantities of money on meetings and ‘conferences’, thereby highlighting what a complete waste of time and money they are. Stu clearly knows this. there’s no accountability and it’s a bad bad idea to naively think that a positive result will not have a profoundly negative effect on one’s ability to live a full life, stigma and marginalisation will follow. All the counselling in the world will not change these facts. I’ve got a full filing cabinet full of unauthorised correspondance

          2. Glad I am not the only one who thinks this!

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