HIV testing in primary care will help improve early diagnosis

HIV is now a treatable medical condition and the majority of those diagnosed with the virus remain fit and well on treatment. Patients living with HIV may well now have a near-normal life expectancy with antiretroviral treatment. In all, 77,000 people are known to be infected with HIV in the UK. However, 28% are unaware of their infection and are therefore unable to access treatment. Late diagnosis is the most important factor associated with HIV-related morbidity and mortality in the UK. The RCP guidelines recommend that GPs should offer an HIV test to patients: from communities or geographical locations where HIV is common; who present with a medical condition in which HIV might be implicated; with a medical condition compatible with AIDS or with any HIV indicator disease. GPs should also consider offering an HIV test to new patients who register with the practice in areas where diagnosed HIV prevalence in the local population (PCT/LA) exceeds 2 in 1,000. The pre-test discussion should cover: an explanation of why the test is recommended; the benefits of testing to the individual; details of how the result will be given; confidentiality and informed consent. The need for a repeat HIV test, if the patient is still within the window after a specific exposure, should be discussed.