HIV in Primary Care Justin Walker November 2011
Learning Objectives • Know when to consider testing for HIV in primary care • To learn the best practice around testing • To know what topics should be covered in counselling • Symptoms and signs of primary HIV • Clinical conditions associated with long term HIV
Programme • Introduction - HPA Annual Report 2011 • Small group work • Feedback within groups • Plenary • Question and answer session • Useful sources of information
Introduction • By the end of 2010, approximately 91,500 people were living with HIV in the UK, of whom about 24% are undiagnosed. • 6,600 people were newly diagnosed with HIV • 50% of these were diagnosed late • These individuals have a tenfold increased risk of dying within a year of diagnosis, compared to those diagnosed promptly (4.0 vs 0.4%).
Introduction • People living with diagnosed HIV can expect a near-normal life expectancy • An estimated 3000 new diagnoses in MSM, the highest ever • In 2010 one in seven overall and one in four MSM had recently acquired infection.
Introduction • More than 2.1 million HIV tests were performed in 2010, most in STI clinic and antenatal settings. • Coverage in STI clinics 69% • Coverage in antenatal care 96%
Areas to Cover • Primary HIV Infection and aetiology • Testing - who and when • Testing - practicalities and counselling • Clinical conditions associated with long term HIV.
Small Group Work • Split into groups of four • Review resources (10-20 mins) • Present summary to other members of the group. Note any questions. (30 mins) • Tea, coffee and lots of cake • Plenary, question and answer session. • Sources of information.
Plenary • Primary HIV Infection and aetiology • Testing - who and when • Testing - practicalities and counselling • Clinical conditions associated with long term HIV.
Key Recommendations I • In high HIV prevalence areas universal HIV testing should take place for all general medical admissions and new registrants in general practice. • HIV testing in STI clinics should be universal.
Key Recommendations II • People most at risk of HIV infection (MSM, black Africans, IVDUs) should have an annual HIV test • People with HIV should have PCV13 to decrease incidence of invasive pneumococcal disease.
Useful Sources of Information • Managing HIV in Primary Care - MedFASH • HIV Annual Report 2011 - HPA • Recommendations for HIV testing 2008 BHIVA • www.hiv-druginteractions.org