International Journal of STD & AIDS > Volume 20, Supplement 1 > Pp. 7-14

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fisher, M Articles by Delpech, V Search for Related Content Social Bookmarking                      What's this?

Supplement

Experience in the UK

M Fisher MBBS FRCP ^*  and V Delpech 

^* Brighton and Sussex University Hospitals, Eastern Road, Brighton BN2 5BE, UK; Consultant Epidemiologist and Head of National HIV Surveillance Centre for Infections, Health Protection Agency, UK

Correspondence to: Dr Martin Fisher Email: Martin.Fisher{at}bsuh.nhs.uk

The number of new diagnoses of HIV in the UK is increasing, with most new diagnoses reported in men who have sex with men (MSM) and black African heterosexuals the later of whom usually acquire their infection abroad. Around 31% of people infected with HIV in the UK are unaware of their diagnosis, and one in three are diagnosed for the first time with a CD4 count <200 cells/mm³ or with AIDS. Late diagnosis is the most important factor that explains most HIV-related causes of death in the UK. Strategies to increase HIV-testing include universal approaches in antenatal and STD clinics (known as genitourinary [GU] medicine clinics), but other opportunities for prompt diagnosis are often missed during secondary and primary consultations – even when patients present with HIV-related illnesses. Furthermore, a significant proportion of people with undiagnosed HIV who attend GU medicine clinics leave without being offered an HIV test or a diagnosis of HIV. Universal offer (opt-out testing) policies seem to work well – such as in the successful antenatal testing programme – but local strategies to increase HIV-testing and prompt diagnosis, such as training courses and rapid HIV-testing initiatives have met with varied success. New national guidelines for the UK have been published and, if successfully implemented, should help to address some of these issues.

Key Words: advanced HIV disease • AIDS • black Africans • guidelines • HIV-testing • late diagnosis • men who have sex with men • mortality • opt-out policy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?