The Health Protection Agency (HPA) recommends that routine HIV testing should be commissioned as a priority for all general medical admissions in high prevalence areas (defined as ≥2 per 1,000 among 15-59 year olds).
HIV testing by general practitioners should be widely promoted, especially in high prevalence areas, although further consideration should be given to the best model of expanding testing in primary care.
On this page we provide links to testing guidelines and other resources to help with the implementation of these recommendations.
The Health Protection Agency collects and publishes data by local authority on the proportion of new HIV diagnoses which are made late (CD4 cell count less than 350) and on the number of people accessing HIV care. Data for your area can be found at the following pages:
This document published in April 2012 aims to provide current and future commissioners with a concise overview of the evidence of acceptability, feasibility, clinical benefit and cost-effectiveness of expanding HIV testing beyond traditional settings.
Expanded HIV testing is defined as the routine offer and recommendation of HIV testing in general medical services, e.g. general practice, or the establishment of HIV testing in other settings.
This report from November 2011 provides the final results from eight Department of Health funded projects to examine models of HIV testing in hospital, primary care and community settings. Projects ran for periods of 3-12 months between 2009 and 2010.
These found that testing was acceptable to patients and effective in detecting previously undiagnosed infections. Cost of introducing routine HIV testing into general medical services was an average of £9 per test for general medical admissions and £8 for new registrants in general practice.
The National Institute for Health and Clinical Excellence published guidance in March 2011 for increasing the uptake of HIV testing in black African and MSM communities. The guidance recommends wide-scale testing in primary, secondary and emergency care settings and called for the development of local strategies to overcome barriers to more widespread testing.
National Institute of Clinical Excellence. 2011. Increasing the uptake of HIV testing to reduce undiagnosed infection and prevent transmission among black African communities living in England [external link]
National HIV testing guidelines developed by the British HIV Association (BHIVA) and the British Association for Sexual Health and HIV (BASHH) in 2008 recommend the routine offer of an HIV test to general medical admissions and to adults registering in general practice in areas where local diagnosed HIV prevalence is greater than two per thousand among 15-59 year olds.
BHIVA UK national guidelines for HIV testing 2008 [external link]