Presentation is loading. Please wait.

Presentation is loading. Please wait.

Increasing the uptake of HIV testing in black African communities in England and among men who have sex with men For primary and secondary care settings.

Similar presentations


Presentation on theme: "Increasing the uptake of HIV testing in black African communities in England and among men who have sex with men For primary and secondary care settings."— Presentation transcript:

1 Increasing the uptake of HIV testing in black African communities in England and among men who have sex with men For primary and secondary care settings 2011 NICE public health guidance 33 and 34

2 What this presentation covers Background Scope Recommendations for primary and secondary care Clinical indications for testing Applying core skills Discussion Find out more

3 Background In 2009 an estimated 86,500 people in England were living with HIV 26% of HIV-positive men who have sex with men are unaware of their HIV status More than 40% of new diagnoses among black Africans in the UK are late, which can lead to poorer outcomes Late or non-diagnosis of HIV increases onward transmission of the virus

4 Recommendations for primary and secondary care Promoting testing for people from black African communities and for men who have sex with men Offering and recommending HIV tests Repeat testing Referral pathways Professional competencies

5 Scope Interventions to increase the uptake of HIV testing to reduce undiagnosed HIV infection among black African communities and among men who have sex with men living in England

6 Where local need is identified, develop tailored materials that: Explain infection and transmission, the benefits of testing, treatment availability and dispel misconceptions Emphasise early diagnosis as a route into treatment to avoid serious future illness Detail how and where to access local testing services Promoting HIV testing in black African communities

7 HIV health promotion at GP surgeries and other locations should use materials that: Encourage sexually active men who have sex with men to test at least annually Present testing as an empowering and responsible act Present a positive test result as a route into treatment Detail how and where to access local testing services Provide information on point-of-care testing and the reduced window period of 4 th generation tests (if available) Promoting HIV testing among men who have sex with men

8 Black African communities: offering an HIV test Routinely offer and recommend an HIV test to those: From a country of high HIV prevalence Who report sexual contact abroad or in the UK with someone from a country of high HIV prevalence Who have symptoms that may indicate HIV or where HIV is part of the differential diagnosis With a sexually transmitted infection Who are sexual partners of men and women known to be HIV positive Men who have disclosed sexual contact with other men Female sexual contacts of men who have sex with men Patients reporting a history of injecting drug use

9 Black African communities: HIV testing in primary and secondary care In areas with high prevalence of diagnosed HIV – where diagnosed cases are over 2 in 1000 of the population - offer and recommend an HIV test: when registering and admitting new patients (primary care and general medical admissions) to anyone who has a blood test

10 Men who have sex with men: HIV testing in primary care Offer and recommend HIV testing to all men who: Register with a practice in an area with a large community of men who have sex with men Register with a practice in an area with a high HIV prevalence Disclose that they have sex with other men Are known to have sex with men and have not had a HIV test in the previous year Are known to have sex with men and disclose they have changed sexual partner or high risk sexual practices Have symptoms that may either indicate HIV, or that HIV is part of the differential diagnosis Are diagnosed with, or request screening for, a sexually transmitted infection Live in a high prevalence area and are undergoing blood tests for another reason Ensure annual HIV testing is part of integrated healthcare offered to men who are known to have sex with men

11 Offer and recommend HIV testing during hospital admittance for men who: are admitted in areas with a high prevalence of HIV disclose that they have sex with men have symptoms that may indicate HIV, or HIV is part of the differential diagnosis Men who have sex with men HIV testing in secondary care

12 Recommend: annual testing to all more frequent testing for those at high risk of exposure repeat testing after the window period for those who tested negative, but have possibly been exposed to the virus Repeat testing for men who have sex with men

13 For everyone: provide information on behavioural or health promotion interventions Positive test: seen by an HIV specialist, preferably within 48 hours; given information about diagnosis and local support Negative test: encourage repeat testing if at risk Test declined: ensure they know how to access testing services HIV referral pathways

14 Clinical indications for HIV testing Patients may present with non-specific symptoms such as malaise and weight loss, or symptoms from a range of clinical areas, including: thoracic medicine gastroenterology oncology dermatology haematology emergency medicine A full list of clinical indications for HIV testing can be found in the UK National Guidelines for HIV Testing, British HIV Association

15 Ensure staff feel able to routinely offer and recommend an HIV test. They should: provide information on testing, discuss why it is recommended and emphasise confidentiality be able to discuss symptoms, and the implications of a positive or a negative test be familiar with referral pathways recognise symptoms that may signify primary HIV infection or co-existing illnesses Professional competencies

16 Offering and recommending a HIV test should be within the existing competencies of health professionals. Resources that may help when applying these core skills to HIV testing include: Tackling HIV Testing: increasing detection and diagnosis (MedFASH) HIV in primary care (MedFASH) HIV for non-HIV specialists; diagnosing the undiagnosed (MedFASH) Applying core skills: HIV testing

17 Discussion What information do we have on HIV prevalence in our region? How do our local protocols deal with offering and recommending HIV testing in general healthcare settings? What steps need to be taken to incorporate HIV testing into new patient registrations? What may help to improve the process of offering HIV testing for elective surgery patients in high prevalence areas?

18 Find out more Visit and for:www.nice.org.uk/guidance/PH33 the guidance the quick reference guides costing report and template slide set for commissioning self assessment tools BMJ Learning module

19 Feedback Did this slide set meet your requirements, and will it help you to put the NICE guidance into practice? We value your opinion and are looking for ways to improve our tools. Please complete this short evaluation form short evaluation form This feedback survey can be accessed by right clicking your mouse over the hyperlink, and then selecting open hyperlink from the menu options


Download ppt "Increasing the uptake of HIV testing in black African communities in England and among men who have sex with men For primary and secondary care settings."

Similar presentations


Ads by Google