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AIM
To provide information enabling any clinician to perform an HIV test within good clinical practice and to encourage normalisation of HIV testing
FACTS & STATISTICS1. Early treatment improves outcome for the individual
& public health
2. Treatment reduces morbidity, mortality & onward
infectivity
3. Early diagnosis & treatment is cost effective
4. 24% of HIV deaths in 2006 were attributable to
diagnosis made too late for effective treatment
5. 1/3 of HIV infective adults in UK remain undiagnosed
Who should be offered a test
1. Universal testing:I. Antenatal servicesII. Drug dependency III. Gum, sexual health & TOP IV. Diagnosed with TB, Hep B, Hep C &
lymphoma
2. Prevalence in local population > 2 in 1000
3. High risk groups:
I. UPSI ( African, SE Asia )
II.IVDU
III.All pts with STI
IV.Contacts of pts known HIV+
V.MSM ( & female contacts)
VI.Country with high prevalence
4. Where HIV may enter the differential diagnosis
• Bacterial pneumonia
• Peripheral neuropathy• Severe seborrhoeic
dermatitis• Severe psoriasis• Recurrent herpes
zoster• Oral candidiasis• Unexplained weight
loss
• Unexplained chronic diarrhoea
• CIN grade 2 & above• Unexplained blood
dyscrasia • PUO• Lymphadenopathy of
unknown cause• Mononucleosis like
syndrome
5. In accordance with existing DOH guidelines
• Blood donors
• Dialysis patients
• Organ transplant donors and recipients
Pre –test discussion
Purpose : Informed consent
Lengthy discussion is not a requirement unless the patient requests or needs this
Low risk & High risk
• Benefits of testing
• Details of how results will be given
• Questions
• Document above
• No need for written consent
High risk in Tayside HIV Services
• What support does the patient have
• Referral pathway
• Occupation & Impact
• Insurances & Mortgages
Results
• Not on a Friday
• Telephone consultation if low risk
• Face to face if:
i. High risk
ii.Mental health issues
iii.English 2nd language
iv.< 16
v. Vulnerable / anxious
Post test discussion
• Negative result:
• Health promotion
• PEP
• Repeat testing
• Positive result
• Referral pathways
• Immediate concerns
• Support
Services in Tayside• Referral pathways
– I.D or GUM ( both have a HIV nurse)
• Same day testing at NW
– Tuesday, Wednesday and Thursday
• Next clinic testing at PRI
– Monday & Thursday
• Body positive Tayside
Websites
• www.bashh.org
• www.bhiva.org
• www.sexualhealthtayside.org