NHS urged to roll out routine HIV testing in GP surgeries
A new study supports the case for rolling out routine HIV testing in GP surgeries, as tens of thousands people across the UK live with undiagnosed HIV.
The study, led by researchers from Queen Mary University of London (QMUL) and the London School of Hygiene & Tropical Medicine, found that offering HIV testing to people at health checks when they register at a new GP surgery is cost-effective and would help save lives.
The new study, published in The Lancet HIV, comes after a study involving over 86,000 people from 40 GP surgeries.
The study looked at a medical trial at GP surgeries in Hackney, where patients were routinely given rapid fingerprick HIV testing as part of the standard health check during registration. Researchers found it led to a four-fold higher HIV diagnosis rate.
According to statistical modelling, researchers say it would take just 33 years for the cost of the intervention to break even, by preventing the further spread of HIV.
There are around 13,500 in the UK living with undiagnosed HIV – leaving their own health at risk and presenting a risk to others, as they will not have undergone treatment and are much more likely to spread the disease.
The researchers called on health care commissioners to invest urgently in the roll out of HIV screening to all 74 high HIV prevalence local authorities in England.
Dr Werner Leber from QMUL said: “We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief.
“This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”
Dr Clare Highton, City and Hackney Clinical Commissioning Group (CCG) said: “Public health, specialist and CCG commissioners should take note of these important results showing the value for money of screening for HIV in primary care.
“This intervention means that people with HIV are able to live longer and healthier lives and the spread of infection to other people is halted.”
Dr Michael Brady, Medical Director for Terrence Higgins Trust, said: “One in seven people living with HIV do not know that they have it.
“Undiagnosed HIV infection puts individuals at risk of preventable illness and death, disproportionally contributes to onward transmission and is an unnecessary burden of cost to the NHS.
“Effective HIV therapy means people can now expect to live a normal lifespan and won’t pass the virus on to anyone else. But testing and early treatment is essential to be able to benefit from this. We urgently need new approaches to HIV testing that are delivered at scale and targeted at those at risk.
“Testing in General Practice is a key component of this because, whilst people living with undiagnosed HIV are not accessing existing HIV testing services, they do visit their GP and there are many missed opportunities to test.
“The UK’s national HIV testing guidance has been recommending HIV testing in General Practices in high prevalence areas since 2008. HIV testing guidelines from NICE recommend the same. This important research demonstrates this approach is cost effective, and may even be cost-saving.
“I hope that policy makers, commissioners and healthcare providers act on these findings and invest in HIV testing in primary care. We have the tools to end HIV transmission in the UK but we won’t achieve that without scaling up testing in General Practice and other community settings.”
