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Home | Articles | Infectious Diseases | HIV Testing Guidelines

HIV Testing Guidelines

Last updated 10th October 2022

Introduction

  1. The elimination of human immunodeficiency virus (HIV) transmission in the UK is now considered to be an achievable ambition.
  2. To attain this target all individuals living with undiagnosed HIV will need to be offered testing and commenced on antiretroviral therapy (ART).
  3. The early initiation of ART, regardless of CD4 cell count, has clear benefit for the individual (with avoidance of morbidity and mortality), their partners (avoidance of transmission by having an undetectable viral load) and public health (reduced community viral load and HIV transmissions).
  4. Although significant progress has been made in the UK, with falling HIV incidence and near universal ART coverage in those diagnosed, there remains a significant proportion who are undiagnosed (7% in 2018), present late (43% in 2018) [1], and continue to experience morbidity and mortality and contribute to the ongoing transmission of HIV.
  5. Given the clear benefits of treatment, both for the individual and public health, more needs to be done to ensure that all those living with HIV are diagnosed promptly and can rapidly access treatment and care.
  6. Those who test negative but remain at risk should have equitable access to combination prevention (including condoms, health promotion and pre-exposure prophylaxis [PrEP]).
  7. All healthcare workers should be able to offer an HIV test in their setting. Lengthy pre-test discussion is not required.

HIV Testing is Recommended For

  1. People belonging to groups at increased risk of exposure to HIV, including men who have sex with men (MSM) and their female sexual partners, black Africans, people who inject drugs (PWID), sex workers, prisoners, trans women and people from countries with high HIV seroprevalence and their sexual partners.
  2. People attending health services whose users have an associated risk of HIV, including sexual health services, tuberculosis (TB), hepatitis and lymphoma clinics, antenatal clinics, termination of pregnancy services and addiction and substance misuse services.
  3. All people presenting with symptoms and/or signs consistent with an HIV indicator condition;
  4. People accessing healthcare in areas with high (>2/1000; if undergoing venepuncture) and extremely high (>5/1000; all attendees) HIV seroprevalence.
  5. Sexual partners of an individual diagnosed with HIV.
  6. An annual test is recommended for PWID, sex workers and MSM, and more frequently for those reporting higher risk behaviours or those also belonging to other groups.

Links

British HIV Association/British Association for Sexual Health and HIV/British Infection Association Adult HIV Testing Guidelines 2020

Content by Dr Gwyneth Jones