Universal-offer HIV testing amongst patients undergoing blood tests in primary care: results from a multi-centre...

The 2016 NICE guidelines recommend offering HIV testing alongside routine blood tests in areas of high HIV prevalence (>2 per 1000 adults aged 18-59). Despite this, implementation in primary care has been limited.

A universal-offer HIV testing intervention was implemented across seven general practices in Brighton and Hove. Data were collected on all blood test appointments between June 2022 and February 2024, including demographics, whether an HIV test was offered, patient acceptance, and test results. Mixed-effects logistic regression was used to assess factors associated with test offer and uptake. An electronic survey was disseminated to staff to gather views on feasibility and acceptability.

Seven sites were recruited, although only four successfully engaged and provided complete data. A total of 6105 HIV tests were conducted, with one new diagnosis identified. HIV testing was offered to 45% of eligible patients, with 74% accepting. Older adults were significantly less likely to be offered a test [aOR 71-80: 0.79 (95% CI: 0.69-0.91); 81+: 0.50 (0.42-0.60)]. Amongst those offered testing, patients aged over 50 were less likely to accept [aOR: 0.72 (0.57-0.91)], with the lowest uptake amongst those aged 81+ [aOR: 0.44 (0.32-0.61)]. Staff reported no barriers to feasibility or patient acceptability.

Routine HIV testing in primary care is well-accepted and can identify new cases. However, site engagement can be challenging, with closer monitoring, support, and rigorous on-boarding processes required.