British HIV Association

December 2017

Nursing

Country of origin: UK

The British Association for Sexual Health and HIV (BASHH) and the British Infection Society (BIS) aim to increase the offer of HIV testing to ensure fewer people go undiagnosed have been welcomed by the Health Protection Agency.

The guidelines recommend that wider HIV testing should be considered in those areas of the country where the numbers of undiagnosed infections are likely to be greatest.

To assist planning by Trusts, the Health Protection Agency is releasing information from its HIV surveillance systems showing those places where undiagnosed infections are concentrated.

Professor Peter Borriello, Director of the Health Protection Agency's Centre for Infections, said: "The Health Protection Agency estimates around 73,000 people are infected with HIV in the UK, and a third of these don't know they have the infection.

"The trouble with so many people being unaware of their infection is that onward transmission is more likely and late diagnosis is associated with more serious HIV disease. Without earlier diagnosis we will not see the reduction in transmission that we need to see, nor a further fall in serious disease.

"Increased HIV testing under the new guidelines should lead to much earlier HIV diagnosis for those that are infected. The Agency fully supports this initiative that aims to raise professional awareness of the importance of early HIV testing and diagnosis, normalise HIV testing, and remove any associated stigma."

A universal offer of HIV testing is estimated to be cost-effective where the HIV diagnosis rate is greater than one per 1,000 tests. However, the evidence on the cost effectiveness of expanding HIV testing in the population of England is sparse.

Therefore, local innovations to expand HIV testing should be the subject of formally designed service evaluations and be sufficiently large so as to better inform the implementation of the guidelines and the development of national policy.

Rates of HIV-infected individuals accessing treatment, which are collated by the Health Protection Agency and provided to PCTs, will assist local areas in prioritising testing policies by showing health professionals where there is likely to be a higher proportion of undiagnosed infection.

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