Advice for Professionals

HIV testing

HIV testing can be offered by any healthcare professional. There is evidence that most individuals who are diagnosed late (CD4 count <350 cells/mm3) have had multiple contacts with medical professionals in the months/years prior to eventual diagnosis, so we would encourage you to offer testing widely and often.

Opportunities for testing:

  1. Screening those individuals who disclose high risk behaviours through a ‘risk assessment’
  2. Testing those who have the signs and symptoms of a ‘seroconversion’ illness (flu like symptoms, often with a rash, but without cough and rhinitis); and
  3. Testing those with clinical indicator conditions, see the National Testing Guidelines 2008

For advice on testing see Medfash primary care (link).  This booklet has useful tips and information on how to introduce a discussion about testing for HIV in primary care/other settings.

Remember the following key points when testing someone with an indicator condition:

  • Normalise: Inform that it’s done routinely alongside other key bloods
  • Verbal consent through informing: No need to get written consent
  • Don’t need to do risk assessment (except seroconversion)
  • Don’t mention insurance unless asked
  • Do inform if positive
  • Do worry if they decline

Referring newly diagnosed patients to the HIV service:

Please contact The Centre on 01392 284966 and ask to have a member of the clinical team call you back.  We will endeavor to see all newly diagnosed patients within 48 hours, and unwell patients can be assessed the same day (in working hours – otherwise refer to AMU). 

For newly diagnosed patients, this new resource is very helpful.

Referring stable/transferring patients to the service:

Please write to:

Exeter

Barnstaple

Dr Sophia Davies
Consultant in HIV Medicine,
The Centre,
31 Sidwell Street,
Exeter,
EX4 6NN
Dr Elizabeth Claydon
Consultant in HIV Medicine
The Centre, Barnstaple
Barnstaple Health Centre
Vicarage Street
Barnstaple
Devon
EX32 7BH

HIV Testing

HIV testing is offered at every appointment in the GU service as part of a routine sexual health check-up. The best (most reliable) way to do this is by taking a blood sample.

We also offer rapid tests (20 minutes) for those who would like a quick answer or prefer not to have a blood test. This may be done by finger prick or mouth swab.

If you have had a recent sexual contact with someone you know is HIV positive, or you believe to be at risk of having HIV, it is important to be assessed by a healthcare professional as soon as possible. You may require what is known as HIV ‘Post-exposure Prophylaxis’ (PEP).

Please see the section Need PEP. 

HIV Testing Kits

Home HIV test kits are available from two websites locally:

www.test.hiv 

This site will send you a finger-prick blood sampling kit which you then return for processing and get the result a few days later; this is available only to those who are at high risk of HIV and their sexual partners.

Go to site

yourship.uk

This is a local website, administered by our colleagues at the Sexual Health Clinic in Plymouth; they will send you a mouth swab test kit which gives you a result at home. This can be sent to any individual living in Devon and Cornwall.

Go to site

If you think you are at risk of having acquired HIV in the last 12 weeks, a blood test at your local clinic may be more suitable for you. The mouth swab test in particular may miss very recently acquired infection.

If you have been involved in an activity with a high risk of HIV transmission in the last 72 hours it may be possible to take a course of medication known as Post-Exposure Prophylaxis (PEP) to try to stop an infection happening.

How to Access Our HIV Service

HIV services are located at Exeter and Barnstaple. HIV clinics are conducted there (within the GU services).

Please contact us to make an appointment on 01392 284983/82 Exeter or 01271 341562 Barnstaple, or ask your current HIV healthcare provider to write to us.

If you are on treatment and are running low on supplies, please make this clear and ask for a member of the clinical team to call you back.

Local services and support

The Eddystone Trust offers support to those living with HIV either when newly diagnosed, at times of crisis or on an ongoing basis. Patients can self-refer or be referred by a health-care professional. A support worker may be available to visit newly diagnosed inpatients on request.

Phone: 0800 3283508

To visit the website for more information, click here.

 

Need PEP?

If you have had recent sexual contact with someone who is HIV positive (or you think they might be positive) it may be suitable for you to take medication to reduce the chances of developing HIV yourself.

It is very important that you see a healthcare professional as soon as possible to be assessed, ideally within an hour(s)of that contact. Tell the receptionist that you think you might need PEP and they will arrange for you to see someone as soon as possible. This can be done during working hours at the following locations:

Exeter Barnstaple

The Centre Exeter
31 Sidwell Street
Exeter
EX4 6NN

(Monday-Friday 0900-1700)

Barnstaple Health Centre
Vicarage Street
Barnstaple
Devon
EX32 7BH

(Monday to Fiday 0900-1600)

All other times - A+E, Royal Devon and Exeter Hospital

All other times - A+E, North Devon District Hospital, Barnstaple

 

Don’t delay seeking medical advice under these circumstances – it is vital to start the medication as soon as possible, if you need it. It will not be prescribed if it is more than 72 hours after the event.

If you have been sexually assaulted and wish to be seen at the Sexual Assault Referral Centre (SARC), a PEP assessment may be done there. Medication can be provided by the SARC team immediately.

What is PEP?

PEP stands for ‘Post Exposure Prophylaxis’. It is a 28 day course of three anti-retroviral drugs (which are exactly the same as the medication used to treat HIV infection).

How does PEP work?

PEP medication may be able (but will not guarantee) to stop the HIV virus from spreading around your body, i.e it ‘aborts’ an early infection.

Useful links

  • i-base (information for patients and professionals about HIV, transmission and treatment, as well as other related topics): click here
  • National aidsmap (clear and accurate information about HIV): click here
  • National AIDS Trust: click here (particularly good section on HIV, stigma and the law)
  • Eddystone: click here
  • British HIV Association: click here
  • British Association for Sexual Health and HIV: click here

Want to Know More about HIV?

HIV is a viral infection that is transmitted via sexual contact, sharing drug-using equipment or via infected blood/medical products. It can also be passed from mother to child in the womb, at the time of delivery or via breastfeeding.

If untreated, HIV can lead to problems with the immune system, unusual infections and cancers, although often people are symptom-free for many years. It can also be unknowingly passed on to other people.

  • There is very effective treatment available for HIV that can prevent most of this happening.
  • People who are diagnosed and treated for HIV have close to normal life expectancy.

If you are sexually active, it is a good idea to get into the habit of having a regular test alongside other routine sexual health tests.

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