One of our strategic goals is to achieve early diagnosis of HIV through ethical, accessible and appropriate testing.
HIV testing rates amongst the groups most at risk are far too low and late diagnosis continues to be far too high. Late diagnosis reduces life expectancy and dramatically increases the likelihood of an early death. It also makes it more likely that an individual has passed HIV on to others. Improved HIV testing is therefore vital to both individual and public health.
- 42% of people diagnosed with HIV were diagnosed late, after the point at which they should have begun treatment
- 66% of Black African men and women were diagnosed late
- 31% of MSM were diagnosed late.
NAT campaigns to influence testing policy to increase testing amongst at risk groups and to increase the overall number of tests offered in healthcare settings.
For more information about when you should test please see our Q&A
on HIV testing or visit www.hivaware.co.uk
NAT’s Testing Priorities
Influencing the commissioning of HIV testing services
NAT want to ensure NHS bodies responsible for HIV testing commission high quality and effective HIV testing services which reduce undiagnosed HIV and late diagnosis. In England a new set of NHS commissioning arrangements for HIV testing services came into place in 2013. We have developed a detailed guide: 'Commissioning HIV Testing Services in England: A practical guide for Commissioners'
to give support and advice on commissioning HIV testing services in England for these new bodies responsible for delivering HIV testing.
Ensuring Self -Testing Kits are available and safe to use
From April 2014, following campaigning by NAT, THT and other organisations, it became legal to sell self-testing kits
in England, Wales and Scotland.
We believe self-testing kits have an important role to play in reaching people who are currently reluctant to test in clinical settings. They also make it easier for those at high risk of HIV to test regularly and frequently. We want any self-test kit sold in the UK:
- to be of high quality and provide accurate results.
- to provide clear information about when you can get an accurate result, on how to interpret the result, and what to do if you get a reactive result.
- to provide information on HIV support and care so that people are linked into care appropriately
- to provide a helpline.
We also want to make sure every self-test kit has the CE mark for use as a self-test to show it has gone through the necessary regulatory processes and can be used safely. NAT and THT are not currently aware of any HIV self-test kit which has the CE mark as a self-test kit.
If you have come across an HIV self-test kit for sale and have further questions as to whether it is advisable to use it, please ring THT Direct on 0808 802 1221.
For more information on self-testing kits please see our fact sheet
. Increasing Partner Notification
NAT’s report shows HIV partner notification can be highly effective in diagnosing people with HIV. NAT want to ensure HIV Partner Notification is consistently carried out across the UK. We are working with BASHH to develop a standard and outcome measures on HIV partner notification to ensure this is consistently implemented. Reducing late diagnosis through ‘look-backs’
The BHIVA Standards of Care for People Living with HIV state that all HIV services should review patients in care who were diagnosed very late (a CD4 count of <200cells/ mm3). Part of the review should involve a ‘look back’ of the patient’s previous engagement with health care services. This information is critical to improving healthcare practice and for increasing commissioners understanding of interventions which can be implemented to reduce late diagnosis. NAT is currently on the BHIVA working group developing guidance on look-backs. We want to see every HIV clinic implement look-backs to reduce late diagnosis. Campaigning for opt- out testing in Initial Accommodation Centres
We believe opt-out HIV testing should be delivered in every Initial Accommodation Centre (IAC) in the UK. IACs house asylum seekers who need Home Office support before they are allocated more permanent accommodation. Data shows IACs are likely to have people coming from high prevalence areas and who may have undiagnosed HIV. HIV tests which have been offered in IACs to people from high prevalence countries have shown to be an effective means to reach those undiagnosed.
Currently there is no guidance around HIV testing in IACs and it is unclear how often HIV tests are offered, if at all. NAT will be campaigning to influence the commissioning of healthcare services in IACS to ensure that opt-out testing can be delivered across the UK to reduce undiagnosed HIV amongst asylum seekers.