Routine HIV tests for new GP surgery patients is cost effective, study finds

Offering routine HIV tests to people registering with new GP surgeries in high risk areas is cost effective and could save lives, a study has shown.

The researchers are calling for HIV screening to be introduced at 74 local authorities in England where there is high rates of infection.

High HIV prevalence is defined as more than two diagnosed infections per 1,000 adults in a given area.

An estimated 13,500 people in the UK do not know they carry the virus that causes AIDS, which means they miss out on treatment and pose an infection risk to others.

Werner Leber, from Queen Mary University of London, who led the study involving more than 86,000 people from 40 GP surgeries, said: ‘We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief.

‘This is an important finding given today’s austerity. Financial pressures, particularly in local authorities’ public health budgets, mean that the cost of HIV testing is under intense scrutiny and in some areas investment in testing has fallen.’

The scientists conducted conducted a trial of the effectiveness of rapid fingerprick HIV testing as part of the standard health check carried out during GP registration. They found it led to a four-fold increase in the HIV diagnosis rate.

Value for money

A mathematical model showed primary care HIV screening in high prevalence areas becomes cost effective after 33 years. But when the higher costs of care for people diagnosed late is factored in, the model shows that screening could become cost effective far sooner than this.

The annual cost of introducing HIV screening to all 74 high-prevalence authorities was estimated to be £4 million.

Clare Highton, from the City and Hackney Clinical Commissioning Group (CCG) said: ‘Public health, specialist and CCG commissioners should take note of these important results showing the value for money of screening for HIV in primary care.

‘This intervention means that people with HIV can live longer and healthier lives, and that the spread of infection to other people is halted.’

The findings appear in The Lancet HIV medical journal.

Normal lifespan

 Michael Brady, medical director the HIV/AIDS charity Terrence Higgins Trust, said the research is important, and shows that the approach is cost-effective and possibly cost-saving.

‘Undiagnosed HIV infection puts individuals at risk of preventable illness and death, disproportionately contributes to onward transmission, and is an unnecessary burden of cost to the NHS,’ he said.

‘Effective HIV therapy means people can now expect to live a normal lifespan and won’t pass the virus on to anyone else. But testing and early treatment is essential [if we are] to benefit from this.

He added: ‘I hope that policy-makers, commissioners and healthcare providers act on these findings, and invest in HIV testing in primary care.’

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