HIV: low prevalence is no excuse for not testing

The article on HIV testing provides a compelling argument for identifying high-risk patients and attempting to diagnose HIV infection early.1 It provided an impetus to review the recorded HIV status of patients from countries of high HIV prevalence in our practice, and we searched and identified 124 patients born in sub-Saharan African countries. Among these, there are a variety of ages and ethnic groups. For the vast majority of these, no HIV status is recorded.

In your editorial, based on 2008 UK National Guidelines for HIV testing, HIV testing should be routinely offered to people from countries of high HIV prevalence. However, no further guidance is offered regarding if we should attempt to contact these patients systematically and, if so, how we should contact them. Clearly the language used in such a communication would be important given the stigma still associated with HIV. Opportunistic testing is an option, but given that some of these patients have not consulted for a number of years could mean that some time could pass before there is an opportunity to discuss HIV testing with the potential for delayed diagnosis.

Could the authors provide some guidance on the next steps we could take having identified a patient from high-risk countries with unknown HIV status?

• © British Journal of General Practice, January 2011