HIV diagnostics

Question 1

Who should get an HIV test?

Answer 1

1. Increased risk group:

MSM;
o Female sexual contacts of MSM; o Black Africans;
o People reporting current or prior injecting drug use;
o Sex workers;
o Prisoners;
o Trans women;
o People from a country with high diagnosed seroprevalence (>1%)*; o People reporting sexual contact with anyone from a country with high diagnosed seroprevalence regardless of where contact occurs; o Individuals known to have/have had a mother living with HIV and who do not have documented HIV-negative status

2. Healthcare settings:

HIV opt-out testing is recommended for all patients attending the following settings:
o Sexual health services; o Addiction and substance misuse services;
o Antenatal services;
o Termination of pregnancy services;
o Healthcare services for hepatitis B and C, TB and lymphoma.
• Individuals commencing chemotherapy or immunosuppressive/immunomodulatory therapy

3. Symptoms of HIV
4. All patients accessing primary and secondary healthcare in areas of high and extremely high HIV seroprevalence, including emergency departments:

o Accessing healthcare in areas of high HIV prevalence (2–5 per 1000) and undergoing venepuncture;

o Accessing healthcare in areas of extremely high HIV prevalence (>5 per 1000), whether or not they are undergoing venepuncture for another indication.

Question 2

HIV test generations and windows

Answer 2

Based on 99th centile

o Fourth-generation laboratory tests, 45 days;

o Third-generation laboratory tests, 60 days;

o All POCTs 90 days.