Time to test for HIV: Expanded healthcare and community HIV testing in England
Health Protection Agency
This report provides the final results from eight projects, in hospital (3), primary care (2) and community (3) settings funded by the Department of Health to examine models of HIV testing in these settings. All except one were in high prevalence areas (where diagnosed HIV prevalence is greater than two per thousand among 15-59 year olds). Projects ran for periods of 3-12 months between 2009 and 2010.
- The routine offer and recommendation of an HIV test in primary care and hospital settings is feasible and acceptable to both staff and patients.
- More than 11,000 HIV diagnostic tests were performed across the pilots, the largest number in healthcare settings. A total of 51 HIV-infected persons were newly diagnosed, giving an overall positivity of four per thousand tests across the projects.
- The majority of settings found positivity rates of at least one per thousand tests, the threshold for cost-effectiveness. The highest positivity rates were reported in community based projects.
- The cost per test conducted within the pilots ranged from £3 to 12 in hospitals settings, from £6 to £8 in primary care settings and from £21 to £47 in community settings.
- Estimates of costs per newly diagnosed individual within pilots ranged from approximately £300 to £3,800 in medical admissions, from £1,200 to £4,600 in primary care settings and from £700 to £2,600 in community settings.
- The pilots demonstrated feasibility and acceptability of establishing HIV testing services in community based settings. Patients showed no preference for nurse-led or peer-led services but the pilots highlighted difficulties in recruiting and retaining staff and finding suitable venues for testing.
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Last reviewed: 20 September 2011