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HIV Rapid testing in GP Surgeries.

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john@tcell.org.uk
Member
Posts: 136
HIV Rapid testing in GP Surgeries.
Posted on: June 24 2009, 11:53 am

From my NAM email yesterday I note the article titled "UK study shows opt out HIV testing at GPs is feasible and acceptable"http://www.aidsmap.com/en/news/197ED409-F285-43F6-BB23-00DC615079F1.asp.

The study mentioned was within London and shows promise.  However I would be particularly interested if there was a comparative study from a GP surgery outside of London and from a large provincial town.

In my experience attitudes towards HIV are often very different from those within London "bubble". 

Whereas I understand the desire to press for testing, one also has to consider the support services available to support PLWHA should a test result for any patient prove to be a + result.
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Rachel Wookey
Member
Posts: 4
Re: HIV Rapid testing in GP Surgeries.
Reply #1 on: June 25 2009, 08:01 pm

I agree that there should be adequate support for both the staff delivering this service and of course for the individual undergoing the testing.  Making it sound 'routine' is all very well and good, but in primary healthcare settings any opportunity to discuss sexual health generally should be embraced and enough is not made of these opportunities outside of GUM/Community testing settings.

It will be interesting to see whether similar research is carried out, as John suggests, in areas outwith London.
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Ben Cromarty
Member
Posts: 451
Re: HIV Rapid testing in GP Surgeries.
Reply #2 on: June 26 2009, 12:00 pm

I'm sure you're aware of the HIV Testing guidelines...http://www.bhiva.org/cms1222621.asp

Of course, guidelines are one thing and what actually happens might be something else! ...but at least there are some guidelines, and BHIVA does regularly audit them, and where needed, modify the guidelines.

These guidelines were somewhat controversial to write, and there was some considerable discussion about them in draft form in UK-CAB. As with anything, it is of course never possible to please everyone, so there will be areas in the guidelines where some people might feel uncomfortable...but it's a start, and provides a framework for clear, positive discussion. Any helpful comments would be welcomed, but ideally should be very clear - along the lines of "replace ...with..." or "add/remove...", rather than just "I don't like/agree with..."

There are other areas where HIV testing is being done...in the community, for example. Teesside Positive Action is one that I know of, and this is being done in a well-thought-out manner.

Regards,
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john@tcell.org.uk
Member
Posts: 136
Re: HIV Rapid testing in GP Surgeries.
Reply #3 on: June 26 2009, 02:21 pm

Of course you are right to point out that where good local support is available in main conurbations there would hopefully be a good outcome. 

The BHIVA standards are not what is in question here.  I just feel that to get a better idea in terms of 'impact assessment' the studies should consider that not everyone lives in London or our other main cities.  Of course such a study would feed the guidelines and one would hope ratify them. In terms of the guidelines there pedigree is solid but implementation and reality can differ.  Many of the people I correspond with tell there GP nothing about their HIV though clearly they have already tested.  Many GP's my own included don't have the time to read all the information etc on HIV as those members of the overall surgery are small and a Cost Benefit Analysis doesn't support more time to be given. So would GP's necessarily be aware of the guidelines in the first place?  I should state my GP is very good but is happy for my consultant to look after all my HIV care.

That said I am sure future studies will ask about GP experience and the picture will soon be clear.

The people who need to test, who ought to know to test, may not do so because of the attitude of local GP, if it is a town - gossip, accessibility of support services including assistance with understanding the condition and any medication etc.. THT's reach is not everywhere and people may have barriers such as distance to overcome to get this help.

I don't work in the healthcare system and so am unable to comment on the impact there.  Rachel seems better qualified than I.

You cannot please all of the people all of the time, very true.  I just feel that sometimes studies based on the London experience differs greatly from the experience outside and that is many people to leave displeased.

I hope this goes well, it has many benefits not least normalising HIV.

Please don't take my initial comment as a criticism merely such a study would I am sure have made a positive contribution to the UKCAB discussions, in a fuller manner.  I guess its the resource "devil" again.

Finally I would like to pick up on something you not only state but is also present in spirit - "helpful comments". As to "don''t like/don't agree" personally unless it is accompanied by the "why" and alternative proposals to move things forward I think any right minded person would be dismissive. I think though, like many things in life is it a constant discussion on improvement and the subsequent actions that matter. 

We are in this together and should take a progressive but minded approach.

Wish you a good weekend.

John.
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