The Case for HIV testing - a quiz for the practice team
You can do this quiz yourself, and you can print it off and use it
with your team members.
This quiz has questions suitable for clinical and non-clinical team
members.
Statements about HIV
Indicate here whether you agree
or disagree with the statement.
In patients on antiretroviral
therapy (ART – HIV medication),
HIV will still progress to AIDS in
around 60% of cases.
YES
Treatment is so good now that it
doesn’t really matter if the
diagnosis is late.
YES
NO
DON’T KNOW
NO
DON’T KNOW
YES
There is no evidence that ART
prevents the virus from being
transmitted to someone else.
NO
DON’T KNOW
People with HIV-related symptoms YES
do not use their GP or practice
NO
nurse.
DON’T KNOW
HIV isn’t relevant because we are
in a low or medium prevalence
area.
YES
NO
DON’T KNOW
YES
I have offered an HIV test to a
patient within the last month.
NO
DON’T KNOW
Statements
about HIV
In patients on
Antiretroviral
therapy (ART – HIV
medication), HIV
will still progress to
AIDS in 60% of
case.
Treatment is so
good now that it
doesn’t really
matter if the
diagnosis is late
There is no
evidence that ART
prevents the virus
from being
transmitted.
Answer & explanations for your team.
Those with HIV infection and who are taking their treatment now have a prognosis that is similar to diabetes, or
better. These patients are now highly unlikely to develop AIDS, although they are at somewhat higher risk of chronic
diseases such has heart disease.
Treatment for HIV is excellent, but the late diagnosis of HIV leaves patients at risk of overwhelming infection or HIVassociated tumours. Some still die in the UK because their HIV was diagnosed late.
Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort
(UK CHIC) Study. LINK TO http://www.bmj.com/content/343/bmj.d6016), BMJ 2011;343:d6016. May M,
Gompels M, Delpech V, et al.
There is excellent evidence that ART prevents the virus from being transmitted to sexual partners, with a proven
reduction in the risk of transmission of over 95%
One of the definitive studies that demonstrates a huge drop in HIV transmission to partners when people are treated
with ART’: Cohen SM et al Prevention of HIV-1 Infection with early Antiretroviral Therapy. New England Journal
of Medicine 365; 493-505. 2011
LINK TO: http://www.nejm.org/doi/full/10.1056/NEJMoa1105243?viewType=Print&
HIV-related presenting conditions are often common - such as seborrhoeic dermatitis, abnormal cervical cytology or
community-acquired pneumonia. Therefore it is not surprising that patients (unaware of their HIV infection) present
in general practice. There is evidence that confirms this happens, and the clinical significance is missed.
People with HIVrelated symptoms
do not use their GP. Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK
(LINK TO PDF TO BE UPLOADED ON MEDFASH SITE) Burns FM, Johnson AM, Nazroo J, Ainsworth J, Anderson
J, Fakoya A, et al.. AIDS. 2008 Jan 2;22(1):115-22.
Missed opportunities for diagnosing primary HIV infection Sudarshi D, Pao D, Murphy G, Parry J, Dean G,
Fisher M.. Sex Transm Infect. 2008 Feb; 84(1):14-6. (LINK TO: http://sti.bmj.com/content/84/1/14.short OR PDF on
Your own
observations &
ideas for action.
Do your team need
information and
education on this?
Do your team need
information and
education on this?
Do your team need
information and
education on this?
Do your team need
information and
education on this?
MEDFASH SITE)
HIV isn’t relevant
because we are in a
low or medium
prevalence area
I have offered an
HIV test to a patient
within the last
month.
There is evidence that the diagnosis of HIV is more likely to be missed in in low and medium prevalence areas.
However with the right education and information , it is possible to be alert to the relatively rare possibility of HIV.
HIV is particularly important to consider in patients with more than one HIV-associated condition in the course of two
or three years,
Within the balanced score card (LINK TO
:http://profiles.hpa.org.uk/IAS/dataviews/report/fullpage?viewId=42&reportId=40&indicator=i426&date=20092011) you can see Local Authority (LA) prevalence of diagnosed HIV among persons aged 15 to 59 year and also
late diagnosis by LA (Percentage HIV diagnoses with CD4 cell count <350 at time of diagnosis).
In most areas of England it will be appropriate to be offering HIV tests very regularly. If you feel unable to
offer HIV tests, flag it up now. If some clinical staff seem reluctant to test, consider how you might take
steps to address this. TIPs has many ideas.
Do your team need
information and
education on this?