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New NAT Report: RITA testing and criminal prosecutions

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Yusef Azad
Member
Posts: 15
New NAT Report: RITA testing and criminal prosecutions
Posted on: August 4 2011, 09:04 am

NAT launches today a a new report, 'HIV Forensics II: Estimating the likelihood of recent HIV infection - Implications for criminal prosecutions'. 

The press release is on the NAT homepage and the report itself can be found on the NAT website at http://www.nat.org.uk/Our-thinking/Law-stigma-and-discrimination/Criminal-prosecutions.aspx

Now in the UK anyone diagnosed HIV positive is also told on the basis of a 'RITA test' whether or not it is likely that they have been infected in the previous six months.  NAT was concerned that these RITA test results might be misunderstood or misused to claim that one can know for sure that someone was responsible for passing on HIV to someone else (for example by being their only sexual partner in the last six months).  The report shows that the tests are not reliable at the individual level to make such judgements confidently and the test results should be interpreted with caution in a court of law.
 
Organisations supporting people with HIV should know about the evidential limitations of RITA test results to advise service users and others accurately.
 
Hard copies of the report are available on request, please email Kate at kate.foster@nat.org.uk.
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Simon Collins
Global Moderator
Posts: 651
Re: New NAT Report: RITA testing and criminal prosecutions
Reply #1 on: August 4 2011, 09:47 am

Hi Yusef

Thanks for your post and the issues it raises are important.

However, RITA testing (previously called STARHS or a 'detuned' HIV test) has been used routinely for at least the last five years for anyone who thinks that they caught HIV in the last six months or so. We have been recommending this on the i-Base phoneline for at least this time and the HPA has been providing the test free.

I'm pretty sure that the same caution for interpreting the results has also always been recommended: ie that this is more accurate for population rather than individual results.

Form a treatment perspective the additional information that an estimated year of transmission brings to someone's healthcare once they are diagnosed HIV-positive is important.

Together with routine CD4 and viral load monitoring and other factors (including severity of seroconversion symptoms) it can help inform the rate of progression and therefore the decision of when to start treatment.

i-Base still get a lot of calls from people who are starting treatment earlier than expected. They thought they would have 5-8 years without treatment, when 25% of people need to start within 1-2 years. Even given the cautions about interpreting the results, many people find it helpful to roughly gauge their history, though as your report rightly highlights, a significant minority of people (at least 30%) are easily mistaken in the source of their infection.

Thanks for the report which is a great overview and clearly explains important aspects of the test. Please could we have print copies for people attending the next CAB Smiley
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Yusef Azad
Member
Posts: 15
Re: New NAT Report: RITA testing and criminal prosecutions
Reply #2 on: August 4 2011, 09:52 am

Hi Simon

I absolutely agree - RITA testing is a key tool in our getting a sense of rates of new infection.  It may also be of some use in partner notification/contact tracing and we would be interested in poeple's thoughts on that.  Our report is simply a 'health warning' around the need for care in using an important epidemiological tool for purposes it was not designed for - i.e accusing people of HIV transmission in a court of law.

best wishes
Yusef
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