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Doctors should offer HIV test to all male patients in some areas

NICE guidance issued as UK-acquired HIV cases nearly double in 10 years

Adrian O'Dowd

Wednesday, 23 March 2011

Doctors should offer all male patients in some areas an HIV test to help prevent spread of the disease, according to new advice from the National Institute for Health and Clinical Excellence (NICE).

The advice has been issued at the same time as new figures were published today by the Health Protection Agency, showing that new diagnoses for people infected with HIV in the UK almost doubled over the past decade from 1,950 in 2001 to 3,780 in 2010.

The new NICE guidance aims to increase HIV testing among men who have sex with men by recommending healthcare professionals offer regular, routine testing to all men in high prevalence areas.

GPs should now 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, or an area that has a high prevalence of HIV, according to NICE.

Hospital doctors should follow similar advice for any men admitted to their hospital.

In the UK in 2009, there were 6,630 people diagnosed with HIV.

More than 40% of the new diagnoses were among men who have sex with men. Of the 30,800 such men in the UK with HIV, it is estimated that nearly 9,000 are unaware they are infected.

NICE recommends the NHS should ensure there are interventions that increase the uptake of HIV testing hosted by, or advertised at, venues that encourage or facilitate sex between men.

This should be in addition to general, community-based HIV health promotion and could include locations such as bars as well as GP practices.

Primary care providers should offer and recommend HIV testing to all men who have not previously been diagnosed HIV positive and who fit into one of several categories including registered with a practice in an area with a large community of men who have sex with men, or registered with a practice in an area with a high HIV prevalence.

Clinicians should also offer tests via outreach in venues where there is high-risk sexual behaviour or in venues sited in areas where there is high local prevalence of HIV.

Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE said: “This new guidance from NICE makes a number of practical recommendations which aim to increase HIV testing by encouraging healthcare professionals to offer it routinely to people in areas where there are a high number of people living with HIV.

“For the individual, there are obvious health benefits to being diagnosed quickly - they can start treatment if they need to and look after their own health, but HIV testing and treatment can also help reduce transmission of the virus.”

Ben Tunstall, Terrence Higgins Trust's head of health improvement, said: “We welcome the introduction of these new guidelines, the first of their kind, as a vital step forward in encouraging gay men to test and engaging health care professionals in the need to offer increased, more easily accessible testing.”

The HPA figures showed that men who have sex with men remain the group most at risk of becoming infected with HIV in the UK and new diagnoses in this group alone have increased by 70% in the past 10 years rising from 1,810 in 2001 to 3,080 in 2010.

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