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Health watchdog says GPs should ‘routinely’ test for HIV

Nick Duffy September 7, 2017
A blood test for HIV

A blood test for HIV (TED ALJIBE/AFP/Getty Images)

An influential healthcare body has recommended that doctors provide routine HIV tests for new patients in high-risk areas.

The recommendation comes from the National Institute for Health and Care Excellence (NICE), which which makes recommendations on healthcare provisions within the NHS.

A new NICE Quality Statement on HIV says: “Young people and adults in areas of high or extremely high HIV prevalence are offered an HIV test by their GP practice when registering or when having a blood test if they have not had an HIV test in the past 12 months.”

It explains: “Increasing the uptake of HIV testing among people living in areas of high or extremely high HIV prevalence is important to reduce late diagnosis.

“Early diagnosis improves treatment outcomes and reduces the risk of transmission to other people.

“Offering HIV testing routinely in GP practices in areas of high or extremely high prevalence will help to ensure that having an HIV test is regarded as routine practice.

“This will help to reduce the stigma that can be associated with HIV testing. As the decision to offer an HIV test will be based on clinical judgement the expected level of achievement against the process measures may vary.”

Blood Test Tubes
Blood test tubes (Getty)

The guidelines also recommend that people “are offered an HIV test when admitted to hospital or attending an emergency department in areas of extremely high HIV prevalence”.

Routine HIV tests are one of the most effective ways of finding people living with undiagonsed HIV. People who are not aware they are living with HIV are much more likely to pass it on to others.

Dr Michael Brady, Medical Director at Terrence Higgins Trust, said: “The quality standard published by NICE today is a very welcome step.

“It gives practical advice for commissioners, service providers and healthcare professionals on what processes need to be in place to improve our approach to HIV testing and how to ensure the guidelines are implemented.

“One in seven people living with HIV do not know that they have it. This not only puts their own health at risk, but also means they may unwittingly pass the virus on to others.

“The benefits of knowing your HIV status are clear: once diagnosed and on effective treatment a person with HIV can live a long and healthy life and can’t pass on the virus. But increased testing and early treatment is essential to ensure everyone can benefit from this.

“Rates of undiagnosed HIV and late diagnoses remain unacceptably high and we urgently need new approaches to HIV testing that are delivered on a large scale and targeted at those at risk.

“Testing in GPs and A&Es in high prevalence areas are essential components because, whilst people with undiagnosed HIV may not be using existing HIV testing services, they do visit their GP​ or hospital, where they could be tested.

“National guidelines have recommended HIV testing in GPs and A&E departments in high prevalence areas for nearly a decade now; but it’s still not common practice and this must change.

“We have the tools to end HIV transmission in the UK but the first step must be an increase in HIV testing. Hopefully the quality standard published today means we’re a step closer to making that a reality.”

An investigation last year found that UK hospitals and GP practices are failing to meet recommendations to offer routine HIV tests to patients.

British HIV Association guidance states that people living in high-prevalence areas for HIV infections should be routinely offered a HIV test when they register with a GP or are admitted to hospital.

However, within the 54 high-prevalence local authority areas in England, the investigation found that 82% were failing to offer HIV tests in hospitals in accordance with the guidelines, while 70% did not fund HIV testing at all GP surgeries.

Two of Scotland’s 14 NHS boards are in high-prevalence areas, but both fail to offer routine tests to new patients. No areas in Wales or Northern Ireland are considered high-prevalence.

More: AIDS, Gay, GPs, Health, HIV, LGBT, NHS, NICE, testing

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