Watch GP, Dr Bill Kefalas explain how HIV testing, diagnosis and treatment has changed and how to make HIV testing part of routine patient care.
Primary health care providers and other health professionals play a crucial role in HIV testing. In 2012, more than 50% of newly notified HIV cases were diagnosed in a primary health care setting. As a health professional, you can:
- Test all people with risk factors and strongly advise regular testing. A simple HIV Testing Table is available for reference.
- Be proactive and offer an HIV test whether or not the patient is attending for sexual health reasons.
- Be aware that patients may not disclose their sexuality or sexual preferences.
- Work with patients who have tested HIV positive to determine who may be at risk and arrange for testing of contacts as soon as possible. A GP contact tracing table is available for assistance in supporting your patients that have recently been diagnosed with HIV.
Reducing HIV transmission will depend critically on earlier identification of undiagnosed HIV infections. Determining HIV status early is important to an enable an individual to access effective treatment and for reducing onwards transmission.
- Compulsory counselling prior to HIV testing is no longer required.
- Diagnostic testing for HIV is available on the Medicare Benefits Schedule.
HIV and Pregnancy
A goal of the NSW HIV Strategy 2012-2015: A New Era is to sustain the virtual elimination of mother-to-child HIV transmission. The Strategy also makes a clear statement that NSW supports antenatal HIV testing being recommended to all pregnant women by their care provider, and conducted with each woman’s informed consent.
A Pregnancy and HIV Information Sheet has been developed, to support health professionals to offer an HIV test and encourage women who are pregnant or considering pregnancy to have an HIV test.
Advances in HIV treatment offer improved health benefits for your patients and the potential to dramatically reduce the risk of passing on HIV. This makes treatment a critical part of HIV prevention. Treatment is now simpler and better tolerated by patients. 90-95% of HIV positive people on treatment have a suppressed viral load.
As a health professional, you can:
Prescribing of HIV treatments
Under the Highly Specialised Drugs Program, the prescribing of HIV treatments is restricted to specialist medical practitioners affiliated with public or private hospitals with appropriate specialist facilities. GPs and other medical practitioners with appropriate training/experience may also receive authorisation to prescribe HIV treatments from the jurisdiction in which their patient resides. Importantly this enables people with HIV to access high quality health care in primary care settings. Information on medical practitioners authorised by the NSW Ministry of Health can be accessed through the ASHM - Trained HIV S100 Prescribers list.
With advances in treatment, an HIV diagnosis is no longer a death sentence. It does, however, still have significant health and social impacts. A continued reinforcement of safe behaviours is vital.
As a health professional, you can:
- Encourage gay men, young people and those with casual and new sexual partners to use condoms.
- Remind patients who are planning travel to pack condoms and be safe - HIV does not take a holiday.
- Have condoms freely available at your service.
- Remind people who inject drugs to always use sterile injecting equipment.
- Know where needle and syringe program outlets are located in your area.