NICE publishes recommendations to increase uptake of HIV testing

Patients at high risk of HIV infection should be routinely offered to be tested in general practices and secondary care, according to a new guideline. 

The National Institute for Health and Care Excellence (NICE) has published draft guidance to increase the uptake of HIV testing in order to reduce undiagnosed HIV in people who may have been exposed to the disease. 

In 2014, an estimated 103,700 people were living with HIV in the UK, of which an estimated 18,100 (17%) were unaware of their infection and at risk of passing it on.

According to NICE, gay men and black Africans continue to bear the most significant burden of HIV and it makes recommendations to increase testing among these groups.

The guideline recommends healthcare professionals offer HIV testing to patients on admission to hospital based on criteria including if the person lives in an area with high prevalence of HIV and is undergoing blood tests for another reason. 

Other criteria include if the person is known to be from a country or community with a high prevalence of HIV and if they are a gay man and have not had an HIV test in the previous year.

NICE also makes recommendations for healthcare professionals in GP surgeries to offer testing to patients fitting similar criteria based on where they live, their sexual orientation and history and their symptoms. 

Jason Warriner, the sexual health and HIV lead on the RCN’s public health forum, said: ‘It is about normalising HIV testing so it becomes a routine part of health care.’

But he added that testing is not as common in secondary care, including emergency care, and GP surgeries compared with sexual health services. 

Practice nurses should be discussing sexual health with patients alongside conversations about alcohol, drug use and lifestyle, according to Mr Warriner.

He said: ‘It is not just focusing on diet or smoking, it is a real holistic approach.’

If a patient is then having a blood test for cholesterol, a nurse can also recommend a HIV test, he added. 

The guideline recommends other measures to increase testing including offering point-of-care testing if a follow-up appointment may be difficult and providing self-sampling kits, in a sensitive manner, to groups and communities with a high HIV prevalence. 

The guidance is under consultation until June 15. 

Click here to read it and to respond to the consultation.