RCP: HIV testing must be normalised to stop the spread of disease

Wednesday, 30 September 2009 12:00 AM

A third of HIV-related deaths could be avoided if testing for the disease was more widespread and more socially acceptable. Concise guidelines* published today in Clinical Medicine, the journal of the Royal College of Physicians, will enable any doctor, nurse, midwife or trained healthcare worker to carry out HIV tests and help drive down late diagnoses of the virus. Treatment for people who discover they are HIV positive a long time after they have contracted the disease can be more difficult and also, while infected, they may have passed on the disease unknowingly.

The guidance calls for tests to be offered to everyone accessing sexual health services, antenatal and abortion services, as well as drug dependency programmes and healthcare services for those diagnosed with tuberculosis, hepatitis B and C and lymphoma. Tests should also be routinely offered to anyone presenting with other clinical indicators for HIV infection or with an identified risk factor for HIV whenever they access healthcare services. The introduction of universal testing is intended to de-stigmatise the process.

Also included in the guidance:

- who can test for HIV

- in what settings a test should be offered

- the key elements to the discussion a clinician should have with a patient before and after testing

- a list of conditions that could indicate that a person could be HIV positive and should therefore be offered a test

While more testing is crucial for identifying those at risk and preventing the spread of HIV, it is also vital that testing remain confidential and voluntary.

Dr Mary Armitage, Former Clinical Vice President of the RCP and Chair of the Medical Foundation for AIDS and Sexual Health (MedFASH) project advisory group, welcomed the publication:

"There are compelling reasons for making the HIV test a routine investigation in many secondary care settings, as set out in these guidelines."

Dr Mark Pakianathan, British Association for Sexual health and HIV (BASHH), commented:

"A 20 year old diagnosed with HIV today can expect to live an additional 50 years with the treatment now available. We have an urgent responsibility to recommend testing when appropriate to avoid unnecessary death and spread of disease."

Notes to Editors

1. For further information or a copy of the guidelines, please contact Zoë Horwich, Communications Officer at the Royal College on Physicians on 020 3075 1354 or zoe.horwich@rcplondon.ac.uk.

2. The publication of these guidelines will be supported by a new HIV testing resource pack for clinicians produced by MedFASH, which will be launched at the British HIV Association Autumn conference 2009, on the 8th October.

*This guidance was prepared on behalf of the HIV Testing Guidelines Writing Committee, and is a summary of the recommendations from the UK national guidelines for HIV testing 2008 produced by the British HIV Association. It is available at www.bhiva.org/cms1222621.asp

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