Recommended groups for routine HIV tests

Indications for HIV testing in Primary care:

• in all areas, offer and recommend HIV testing to everyone who has not previously been diagnosed with HIV and who:
  
  
  • has symptoms that may indicate HIV or HIV is part of the differential diagnosis (for example, infectious mononucleosis-like syndrome), in line with HIV in Europe's HIV indicator conditions - see linked item
    
    
  • is known to be from a country or group with a high rate of HIV infection
    
    
  • if male, discloses that they have sex with men, or is known to have sex with men, and has not had an HIV test in the previous year
    
    
  • is a trans woman who has sex with men and has not had an HIV test in the previous year
    
    
  • reports sexual contact (either abroad or in the UK) with someone from a country with a high rate of HIV
    
    
  • discloses high-risk sexual practices, for example the practice known as 'chemsex'
    
    
  • is diagnosed with, or requests testing for, a sexually transmitted infection
    
    
  • reports a history of injecting drug use
    
    
  • discloses that they are the sexual partner of someone known to be HIV positive, or of someone at high risk of HIV (for example, female sexual contacts of men who have sex with men)
    
    
• in areas of high and extremely high prevalence, also offer and recommend HIV testing to everyone who has not previously been diagnosed with HIV and who:
  • registers with the practice or
  • is undergoing blood tests for another reason and has not had an HIV test in the previous year
  • additionally, in areas of extremely high prevalence, consider HIV testing opportunistically at each consultation (whether bloods are being taken for another reason or not), based on clinical judgement (1)
    
    
• offer and recommend repeat testing to the people in recommendations above if:
  • in groups or communities with a high rate of HIV, and more frequently if they are at high risk of exposure (in line with Public Health England's HIV in the UK: situation report 2015). For example:
    • men who have sex with men should have HIV and sexually transmitted infection tests at least annually, and every 3 months if they are having unprotected sex with new or casual partners
    • black African men and women should have an HIV test and regular HIV and sexually transmitted infection tests if having unprotected sex with new or casual partners

Notes: (2)

The most recent UK-wide estimate is that around 107,000 people are living with HIV in the UK. Of these, around 5,000 are undiagnosed and do not know they are living with HIV.

New diagnoses have been increasing since 2021. Prior to 2021, new diagnoses were declining since their peak in 2005. In 2023, there were 6,512 HIV diagnoses in the UK excluding Northern Ireland, a 46% rise from 2022.

• Of the people for whom probable exposure is known, 95.4% of people accessing HIV care in 2022 acquired HIV through sexual transmission. The number of people who acquired HIV through sex between men and women (48.6%) is slightly higher than the proportion of people who acquired HIV through sex between men (46.9%)

Of all the people whose ethnicities are known and who received specialist HIV care in the UK in 2022:

• 53.7% were white of the people receiving HIV specialist care in the UK in 2022 were white.
• 30.2% were Black African.
• 4.6% were Asian, 2.9% Black Caribbean and 2.3 “Black other”
• 6.3% were of “Other” ethnicity.
• Almost half (49.8%) of people accessing HIV care in 2022 were aged 50 or over, and 8.9% were 65 or over.

Reference:

1. NICE (December 2016). HIV testing: increasing uptake among people who may have undiagnosed HIV
2. UK National Aids Trust 2024. UK HIV statistics.