The case for HIV testing

A presentation for the clinical team

in your practice

Why test for HIV?

Work in pairs

Try to think of at least two reasons

why it is good practice to offer HIV tests

HIV and STI Department

Annual new HIV and AIDS diagnoses and deaths: UK, 1981-2012

Graph kindly provided by Public Health England

ART availableHIV test

developed

Prevalence of HIV in the UK2012An estimated 98,400 people were living with HIV.

• The overall prevalence is 1.5 per 1,000 population

22% were unaware of their infection.

Prevalence much higher in some communities• 47 per 1,000 among men who have sex with men (MSM)• 37 per 1,000 among black Africans

HIV prevalence continues to be significantly higher in London than elsewhere in the UK.

• The most deprived areas have the highest prevalence, especially in London.

HIV and STI Department

New HIV diagnoses by exposure group: United Kingdom, 2002 – 2012 * *Data have been adjusted for missing exposure information

What is late diagnosis?

Association between virological, immunological, & clinical events and time course of untreated HIV(Reproduced with permission from e-GP: e-Learning for General Practice, RCCP)

Defined by who should have started treatment already.ie when CD4 count below 350 cells/mm3

In 2012, 47 % of adults diagnosed in the UK were diagnosed late

They were ten times more likely to die within a year of diagnosis

Also higher risk of •permanent disability•acute serious illnesses•slower response to treatment•onward transmission of infection

Late diagnosis

HIV and STI Department

HIV and STI Department

HIV and STI Department

Late diagnoses of HIV by exposure group: United Kingdom, 2011

HIV and STI Department

Late diagnoses of HIV by exposure group: United Kingdom, 2011

HIV and STI Department

Late diagnoses of HIV by exposure group:United Kingdom, 2011

HIV and STI Department

Trends in late diagnosis (CD4<350)by exposure group: UK, 2002-2011

Now add to your list

Can you think of any more reasons that it is good practice to test for HIV?

Add them to your list

Choose 3 to 6 key facts on HIV

What would you want a receptionist to know?

What would you want patients to know?

Make a list on the flip chart

Discuss and agree how you would like to circulate this-To your team?-To your patients?-Who is responsible? / completion date

Use HIV testing

You might save a life!