Patients in Emergency Departments (EDs) in all London NHS hospitals will now be offered HIV tests, as NHS England announces the expansion of opt-out routine
testing across London.
While some trusts have already been implementing opt-out HIV testing, successfully identifying undiagnosed HIV and offering effective early treatment, the
initiative has now expanded to every NHS trust in London. Hepatitis B and C will also be checked as part of the combined blood borne virus testing approach.
With 42% of HIV diagnoses in the UK made late, at a point when the immune system has already been significantly damaged, early identification is key in
preventing ill-health, premature death and onward transmission. People with a late diagnosis are eight times more likely to die from the illness.
In 2020 across England, 29% of gay and bisexual men were diagnosed late, compared with 59% of Black African heterosexuals. ED opt-out HIV testing is an
effective way to reach members of these communities, who may not come into contact with other HIV testing opportunities.
In London, more than 1,600 people were living with undiagnosed HIV in 2020, which is around a third of the estimated number of people in the UK who are
not aware they have the virus.
Oliver Brown, serving in the Royal Navy, said:
“I was 29 when I went to A&E after coming off my bike with one of my fingers badly sliced during the fall.
“Had Chelsea and Westminster Hospital not been part of a routine HIV opt-out testing programme in Emergency Departments, I may still be unaware of my status.
“As a naval officer, I faced challenges following my diagnosis, fearing the stigma associated with being HIV positive. However, through engaging and educating,
the blanket ban on people with HIV being able to serve our country has been lifted and now individuals taking medications such as ART and PrEP are recognised as fully fit to serve in our Armed Force.
“Routine opt-out testing in A&E departments saves lives, it saved mine and stopped me passing on the virus to others.”
Since
HIV opt-out testing became routine in some EDs in 2016, HIV diagnoses have significantly increased, detecting patients who otherwise may not have found out they were positive until later.
At West Middlesex University Hospital, 66% of new HIV diagnoses within the last year have come from testing in EDs.
Croydon University Hospital began opt-out testing for HIV in early 2020 and have managed to sustain a 97% testing rate for over two years.
Ward patients presenting with AIDS-defining illnesses in Croydon have halved in number since 2019 and are two-thirds fewer than a decade ago.
Dr Ian Cormack, clinical lead at Croydon University Hospital said:
“Emergency Department testing is a brilliant initiative that means more patients get support and treatment right away, preventing the development of serious
AIDs-defining illnesses and ultimately saving lives. At Croydon this has tripled our hospital’s rate of HIV diagnosis and has dramatically improved patient outcomes.
“It’s so important because very few people expect to test positive, and without this testing initiative they may not have been diagnosed until they become
very unwell. Death or significant harm from HIV is now mostly a thing of the past thanks to earlier diagnosis and treatment.
“HIV treatment ensures good health and also prevents onwards transmission, helping the UK achieve its target of eliminating new HIV infections by 2030.”
