1. Introduction to the...

2. HIV in the UK Over a quarter of those infected remain undiagnosed – HPA 35% of HIV-related deaths attributable to late diagnosis – BHIVA audit Effective treatments greatly reduce morbidity Improved response if started early Treatment can also reduce onward transmission

3. Richmond House 79 Whitehall London SW1A 2NS 13 September 2007 Dear Colleague Improving the detection and diagnosis of HIV in non-HIV specialties including primary care 1.We are writing to ask for your help in combatting the continuing threat of HIV infection to the public health. A special effort on your part would do much to improve the situation. SIR LIAM DONALDSON PROFESSOR CHRISTINE BEASLEY CHIEF MEDICAL OFFICER CHIEF NURSING OFFICER Chief Medical Officer letter

4. Why new guidelines?

5. Who can test? Any healthcare professional

6. Who to test? Universal testing by setting By local HIV prevalence Patient groups by risk Clinical indicator conditions

7. Who to test? Universal testing by setting

8. Who to test? By local prevalence Full information on HIV prevalence by PCT can be found on the HPA website: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1201767906579

9. Who to test? Patient groups by risk

10. Who to test? Clinical indicator conditions – general medicine

11. Clinical indicator conditions – medical specialties Who to test?

12. Clinical indicator conditions – surgical specialties Who to test?

13. Clinical indicator conditions – oncology Who to test?

14. Clinical indicator conditions – other Who to test?

15. Which test to use?

16. What should be a reasonable time to receive a result?

17. Other areas covered within the guidelines Pre- and post-test discussion Confidentiality Community based testing Testing children and where consent is lacking Testing and criminal prosecution Testing and insurance Auditable standards

18. Summary Undiagnosed HIV a significant problem –Individual and public health Individuals with undiagnosed HIV access healthcare –but the diagnosis is frequently missed Increased testing should reduce the problem –Universal by setting –Routine screening in high prevalence areas –Groups at higher risk of infection –Clinical indicator diseases in all areas

19. 19 Also contains UK National Guidelines for HIV Testing 2008 from BASHH/BHIVA/BIS Available from: enquiries@medfash.bma.org.uk or 020 7383 6345