Challenges

Published: 30 June 2012

The National AIDS Trust (NAT) have issued, in 2009 and 2012, two versions of an 'action plan' for HIV testing,1 with recommendations for how to increase the uptake of HIV testing and reduce late diagnosis. NAT is supportive of the testing guidelines, but notes some challenges to their implementation:

  • In the context of the new fragmented commissioning arrangements, the difficulty of developing and implementing a coordinated strategy to promote appropriate HIV testing.
  • Lack of government endorsement of the guidelines produced by BHIVA/BASHH/BIS or NICE.
  • Unsustained funding for programmes which aim to reduce undiagnosed HIV.
  • The need to make greater use of financial incentives to ensure that general practitioners and other health workers implement the guidelines.
  • Agreeing targets and audits in relation to implementing the testing guidelines.
  • Training for healthcare professionals, particularly non-HIV specialists, to identify risk, early symptoms of HIV infection and how to offer a test sensitively.
  • Getting needed support from relevant clinical bodies to implement the new testing guidelines including non-HIV specialties.

In relation to the latter point, it is worth noting that leaders from other clinical specialities have been hostile to the idea of implementing wider HIV testing within their services. For example, in 2011 the College of Emergency Medicine issued a position statement which said that accident and emergency departments were not suitable environments for ad hoc HIV screening programmes.2

Much more positively, in January 2012 the government announced that late HIV diagnosis would be one of the 66 indicators by which local authorities should measure their progress in improving public health. It is hoped that this will encourage local authorities and NHS organisations to make more effort in relation to HIV testing.

References

  1. National AIDS Trust (NAT) Early testing saves lives. Second edition. Available online at: http://www.halveit.org.uk/resources/Halve_It_Position_Paper.pdf, 2012
  2. College of Emergency Medicine CEM Position Statement - HIV testing in the Emergency Department. , June 2011
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.