Testing for HIV
If there has been possible exposure to HIV within the last 72 hours, please consider urgent referral for Post-Exposure Prophylaxis for HIV (PEP).
Any healthcare professional can test for HIV and all that is required is verbal consent. Read the BHIVA HIV testing guidelines.
An HIV blood test is indicated if an individual belongs to one of the high risk groups or has been diagnosed with an HIV clinical indicator condition, has had possible sexual exposure since their last HIV test.
SHiP health advisers are available to offer you advice on testing (01752 431804).
The standard HIV blood test is known as the ‘combination’ antigen-antibody, or ‘4th generation’, HIV test. This detects both HIV p24 antigen and HIV antibody (which appears a week later than the p24 antigen). A similar combination test is available as a fingerprick point of care test.
The accuracy of the test evolves as below:
- at 4 weeks from HIV exposure, the HIV test will detect 95% of infections
- at 6 weeks, the HIV test will detect >99% of infections
- at 12 weeks, the HIV test will detect >99.9% of infections
Managing HIV in primary care
Antiretroviral (ARV) Drug interactions
Drug-drug interactions occur with many common prescription as well as over the counter (OTC) drugs, and these can have serious consequences. Examples include acute Cushing’s syndrome with some steroid inhalers, as well as antiretroviral (ARV) regimen failure.
Liverpool University provides an excellent and easy-to-use ARV interaction checker.
Vaccinations for people living with HIV
People living with HIV require specific vaccinations because they are more susceptible to infections, more likely to have severe disease and less likely to respond to vaccination than immunocompetent individuals. Conversely, they may also be at risk from
Here is a summary table of HIV vaccination recommendations.
Cervical Cytology in HIV positive women
Women with HIV require annual cervical screening. This must be documented on the sample request form or the sample may be rejected by the laboratory. Multifocal intraepithelial neoplasia is commoner in women with HIV than those without. Symptom enquiry and external anogenital examination is advised when taking a cervical smear.
For women diagnosed with HIV after the age of 25, particularly those with previous cervical abnormalities or a long interval since last screening, colposcopic evaluation as well as cervical cytology should be offered where resources permit.
Our HIV services
The HIV service is part of the Peninsular HIV network. Appointments are available for patients throughout our standard opening times.
We have four specialist HIV consultants with expertise in all areas of HIV including PrEP, PEP, HIV seroconversion, HIV transmission, pregnancy, ARV treatment and inpatient care. Our HIV Clinical Nurse Specialist (CNS) supports patients with all aspects of their care and reviews routine, stable patients at 6-monthly intervals.
We work closely with other teams within the hospital such as the hepatology, obstetric and respiratory departments when managing patients with HIV.
The Eddystone Trust (01752 254406) provide practical and emotional support at any stage of HIV – newly diagnosed, adjusting to being positive, crisis management and living with HIV. Services include Motivational Interviewing, peer support, medication adherence, disclosure and testing including pre & post- test discussion. They offer a condoms-by-post scheme and safer sex resources.
New HIV diagnoses
We give advice on testing and how to communicate a reactive test result. Please contact our sexual health advisers (01752 431804) immediately on receipt of a positive result. We will see a patient newly diagnosed with HIV within 72 hours of being contacted. After an initial assessment and confirmation of the reactive result, the patient will be seen by an HIV specialist within 10 working days.
We follow BHIVA guidelines in our management of HIV patients. These days patients often start ARV therapy shortly after diagnosis for improved health outcomes, and to prevent onward transmission to sexual partners.
All our HIV positive patients have a ‘Patients Know Best’ electronic patient held record. As their GP you are able to share access to this record with the consent of the patient. This allows you to see clinic letters, blood results, ARV care plans and have direct electronic communication with the HIV team as well as the patient.
Stable patient management
Once people are established and stable on ARV therapy we recommend 6 monthly reviews. We send update letters to GPs annually – more frequently if there are changes in management.
To get in touch call 01752 431124 and choose option 6.
HIV resources for patients and professionals
British Association for Sexual Health and HIV (BASHH)
British HIV Association (BHIVA)
BHIVA Safer Sex Guidelines
UK National Guidelines for HIV Testing
BHIVA PrEP Guidelines
BHIVA PEP Guidelines
BHIVA HIV in Pregnancy Guidelines
BHIVA Sexual Health and Living with HIV
MedFASH ‘HIV in Primary Care’
Vaccines for People Living with HIV
Interactive drug-drug interaction checker for HIV medications