Practice 10-minute consultation

The offer of an HIV screen for an asymptomatic adult

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.i6656 (Published 19 January 2017) Cite this as: BMJ 2017;356:i6656
  1. Deborah Kirkham, ST5 in genitourinary and HIV medicine1 ,
  2. Manpreet Bains,, GP trainee and clinical fellow at CQC2
  1. 1Health Education North West, Manchester, UK
  2. 2Public Health England, London, UK
  1. Correspondence to D Kirkham deborah.kirkham{at}nhs.net

What you need to know

  • An HIV test is not a specialist investigation

  • In areas of low prevalence, offer testing to individuals in a high risk category and their contacts

  • In areas of high HIV prevalence (≥2 per 1000) in the UK, offer more systematic screening to those registering with a GP, admitted to hospital, or having a blood test, even if they are not in a high risk category

A 65 year old woman comes to you for monitoring of her thyroid function tests. Your practice is in an area where HIV prevalence is 2.5 per 1000. You wonder whether and how to offer her a HIV screening test.

What you should cover

History

Offer screening to all eligible patients regardless of their risk status. This means a detailed sexual history is not routinely required.

For a screening test a single question may suffice:

We are in an area where HIV is fairly common, so we offer an HIV test to every new patient that registers with us/everybody admitted to hospital/everyone having a blood test. Would you like to be tested? Have you got any questions?”

You may ask the patient if they have been tested before and if they think they may be at risk of HIV. Tailor information to …

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