To mark national HIV testing week, guest blogger Dr Thomas Patel-Campbell provides an overview of HIV and the benefits of testing. Dr Thomas has been a GP for 7 years and is currently working within the Haxby Group Practice, based in York.
What Is HIV / AIDS
HIV is a virus that is transmitted through bodily fluids. Usually this occurs by sexual contact with someone infected with HIV, through sharing needles, or with untested blood products (though this is unlikely with modern testing in the UK). If untreated, this infection damages the body’s ability to fight infection, and can lead to rare forms of cancer. Once the immune system is affected and these infections and cancers develop, we call this AIDS.
Treatment Over the Years
The treatment of HIV and prevention of AIDS has dramatically improved since the condition was first discovered in the 80’s. With modern treatments this condition becomes almost impossible for a patient to transmit to others, if treatment is taken as prescribed, and their routine blood tests are reassuring. In fact, some now consider HIV to be a long-term condition like high blood pressure, treated easily with regular medications, whereas in the 80s it was usually terminal. Treatment involves taking medications every day, but the number of tablets required has reduced as the treatments have been developed over the last few decades, as well as new developments into injectable medications that are only needed every few months.
Developments in Testing
Many of the early symptoms of HIV infection are mild and like other viral infections, such as a sore throat, mild rash, glands swollen and tender, and a fever. These usually settle relatively quickly. The challenge is that after these symptoms resolve, there is a prolonged period when the virus replicates and starts to damage the immune system. During this time there are usually no symptoms at all. This changes once AIDS develops (usually years after initial infection), at which point treatment is difficult.
Thankfully, we have effective investigations for HIV. Many tests can identify HIV 4 weeks after transmission. This is important, as we can confirm if patients have HIV (even though they have no symptoms) and start them on treatment as soon as possible. Tests for HIV can be done using blood taken from a vein by a healthcare professional (venous sample), but this requires an appointment or attendance at a walk-in service. Newer tests can detect HIV status from either a finger-prick drop of blood or an oral gum swab. This is very convenient and can be done anywhere, including privately by a patient in their own home. While these self-tests are reliable provided the instructions are followed, they do require a formal blood test by a healthcare professional to confirm diagnosis.
Assessing Patient Risk and HIV Status
We know that certain groups are more at risk of contracting HIV. The number of infections was previously highest in gay men, but increasingly we are seeing transmission in straight relationships. The number of patients with HIV infection also varies dramatically across the UK, and some countries have a much higher HIV infection rate. There are clear public health benefits, as well as personal benefits to individuals, to widely offer HIV screening tests for those without HIV symptoms (especially those in high-risk groups or areas of high numbers of infections), to ensure that we pick up infection at an early stage when it is easier to treat. With early treatment, many patients’ life expectancy is similaras those who don’t have HIV.
Preventing Onward Transmission Through Effective Testing
Another importance of testing is to protect other people. With HIV infection rarely showing symptoms, people can transmit the infection to others (such as during sexual contact) without realising. By diagnosing and effectively treating these individuals we can prevent transmission of HIV. The UK is a world leader on this, with a target to eliminate new HIV infections by 2030. This is a remarkable achievement considering that 40 years before this date a HIV diagnosis was effectively a death sentence.
Sexual Health Testing Linked to HIV Testing
HIV is usually a sexually transmitted infection (STI). Patients who have an STI are at a higher risk of other STIs such as chlamydia. That’s why any positive HIV test would be followed by testing for other STIs, and why most sexual health services will test patients requesting a routine screen for chlamydia, gonorrhoea, and syphilis as well as HIV.
Accessing Support & ‘Knowing Your Status’
Finally, if you are unsure if an HIV test is the right thing for you, please contact your local sexual health service. All circumstances are different, and the advice above may not suit everyone. A direct discussion with a specialist will ensure that individuals get the testing and treatment they need. They will provide confidential advice on what you should do and can advise on your different testing options. It is easier to treat all STIs if they are detected early, so if you think you may have an STI act now, seek advice, get a test, and get treatment.
TEST. KNOW. ACT. Abingdon Simply Test
Author: Dr Thomas Patel-Campbell | Credentials: Graduated from UCL with a BSc in Infection (2008) and MBBS (2011). Dr Patel-Campbell completed his GP training in North London in until 2016 and took up a post as a salaried GP with Haxby Group. Dr Patel-Campbell became a Partner in 2018 and Director of Clinical Operations in 2020. Chair and Council Rep for Humber & the Ridings Faculty, RCGP.
The content of this blog is for informational purposes only. The content is not a substitute for tailored individual medical advice or consultation with a medical professional. Always seek the advice of a medical professional following any HIV test result or to answer any questions or concerns you have regarding your HIV status.