A London NHS trust is offering all hospital outpatients an HIV test, regardless of why they are there, to tackle the fact that a fifth of people in the UK with HIV are unaware of their infection.
Patients coming in to six hospitals across in east London this week for anything from follow-up appointments to routine blood tests will all be offered an HIV test.
The initiative is part of a national drive to get more people in the UK tested. Around 100,000 people in the UK have HIV, but experts estimate that around one fifth are unaware of their diagnosis because they have not had a test. This means not only that their condition can become more advanced and harder to treat, but also that they could unintentionally infect others.
Thousands of patients pass through NHS hospitals every day – but at the moment, HIV testing is limited to only a few specific areas.
Dr Chloe Orkin, HIV testing lead for Barts Health NHS Trust, said: “We are used to seeing health messages all the time in hospitals about stopping smoking, or having a flu jab. Messages encouraging HIV testing should take an important place amongst them.”
We are used to seeing messages about stopping smoking. Messages encouraging HIV testing should take a place amongst them. Dr Chloe Orkin, Barts Health NHS Trust
The trust aims to test 2,500 outpatients across six London hospitals this week, including the Royal London, in what is thought to be the biggest testing campaign of its kind ever in the UK. It wants to remove the stigma of an HIV test.
HIV infection remains one of the UK’s most important communicable diseases, according to Public Health England. And the problem is worse in some areas, including east London – where people are three times more likely to have HIV than elsewhere in the UK.
But a positive diagnosis is a long way from the “death sentence” that it used to be seen as in the 1980s. Medical advances mean that people diagnosed promptly can expect a near normal life expectancy.
Alan, a 70-year-old Londoner, spent 12 months of illness recently without a diagnosis because none of the doctors who saw him thought of offering him an HIV test.
“Nobody thought to test me for HIV. When I was finally asked if I was willing to be tested I immediately said: ‘Yes, by all means, let’s get that out of the way,'” he said.
“Having been found to be positive at almost seventy years old was a massive shock but once it had sunk in I did feel somewhat let down that nobody had suggested it before, despite the otherwise wonderful care I had received.
“We need to take away the stigma of being tested for HIV so that it becomes a routine test for people visiting hospital irrespective of their gender, ethnicity or age.”
An earlier, smaller pilot at the hospital earlier this year found eight people who were not aware they were HIV positive and who are now receiving treatment. Doctors hope to help more people with the new testing push. Results will be made available within a week and anyone who tests positive will be offered continuing treatment.
Clinicians and HIV charities are united in the belief that testing in this manner is the way forward, but there are issues with cost. Student doctors are providing the tests at the hospital this week.
But Barts NHS Trust says testing like this would ultimately save money. It costs around £5 to do an HIV test and around £5,000 a year to keep an HIV positive person healthy, but it can cost £500,000 to treat someone who is diagnosed late and who needs costly treatments in hospital.
“We want to make it normal for staff to offer HIV tests, and normal for patients to accept them,” said Dr Orkin.
“If a doctor missed a diabetes or cancer diagnosis people would be very upset. Diagnosing HIV patients late by not testing them is just as serious and we need to change this.”