Exclusive: Half of GPs want to offer HIV tests

Almost half of GPs would be willing to offer their patients opt-out HIV tests, a survey by GP has revealed.

Sir Liam Donaldson

The findings coincide with a letter to all practices from CMO Sir Liam Donaldson urging GPs and other healthcare staff to test patients for HIV to improve early diagnosis.

People often present to their GPs with the first signs of HIV, although symptoms can vary.
‘HIV testing in general practice would therefore expedite referral directly to HIV services thereby saving time and decreasing morbidity,’ wrote Sir Liam.

An audit by the British HIV Association into deaths among adults with HIV showed that late diagnosis accounted for at least one in three HIV-related deaths.

Out of 226 respondents to our survey, 46 per cent said they would be willing to provide opt-out HIV tests, even though there is currently no payment for the service.

Among those who said they would not want to offer opt-out HIV tests to patients, 80 per cent said insufficient time for counselling was a major reason.

No payment, the problem of contact tracing and concerns of legal or insurance issues were other common factors.

But in his letter, Sir Liam says lengthy pre-test counselling is not needed and a patient having had a HIV test, if negative, does not need to be disclosed to insurers.

Dr Chris Ford, north London GP and a member of the RCGP sex, drugs and HIV task group, said: ‘HIV testing is not difficult to do. One of the things we are pushing for is normalisation of the test.

‘The RCGP is working towards making GPs aware of common diagnoses that may be the first signs of HIV.’

Shingles, unusual skin rashes including sebaceous dermatitis, genital and chest infections that fail to respond as expected to treatment, unusual weight loss and even impetigo all warrant a test for HIV, said Dr Ford.

The survey found 17 per cent of GPs said they never carry out HIV tests. But over 18 per cent said they carry them out on a weekly or monthly basis.

When asked what was the most important thing general practice can do to improve patients’ health, 42 per cent of GPs in our survey said education and promotion of safe sex.

Additionally, more than one in five GPs (22 per cent) said it was important that patients found their GPs approachable and open to discussion about sexual health.


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