HIV screening guidance - ignored or forgotten?

Abstract

NICE guidance states new patients aged 15-59 registering at a primary care centre in a high-risk area for HIV, should be offered testing. First, this allows for prompt initiation of antiretroviral therapy, improving the individual's morbidity and mortality while reducing community transmission. Second, increasing the breadth of the population offered tests would help normalise testing, reducing stigma and increasing uptake. AIM: To retrospectively audit adherence to HIV testing guidance in new patients registering at a GP in Walsall, where HIV risk is categorised as high, and to make recommendations based on the results. The EMIS records of 310 new patients aged 15-59 who registered during a 12-month period (October 2021 to October 2022) were accessed to establish if they were offered HIV testing. A survey was created and distributed to staff in the practice to understand the reason for lack of testing. The audit revealed that none of the 310 patients were offered an HIV test. The survey indicated that 75% of staff members were unaware of the guideline, 66.7% never ordered an HIV test, and 83% stated that they do not believe GPs are given enough support to follow guidelines. The guidance for screening for HIV in this primary care centre is therefore not followed due to a lack of awareness of the guideline and HIV risk in the area. We recommend that this audit is conducted across more primary care centres in HIV high-risk areas to assess if this outcome is representative of general adherence to guidance.