Professor Jane Anderson
Consultant Physician in HIV Medicine at Homerton University Hospital in Hackney
In recent years, there have been huge breakthroughs in treatments for HIV. This is a immensely welcome step forward notes Professor Jane Anderson, Consultant Physician in HIV medicine at Homerton University Hospital in Hackney. It means that, with early intervention, people diagnosed with HIV can expect to live as long as those who are HIV-free.
However, a range of better treatments doesn’t mean that the threat of HIV has disappeared. In fact, more people than ever are living with HIV in the UK. Figures from HIV Aware show that one in 20 gay and bisexual men are living with HIV; and one in five of that number are undiagnosed. “We have lost our early impetus,” says Professor Anderson. “There has been less coverage in the media and a pervasive sense that ‘it couldn’t happen to me — but, even if did, treatment is available.’ So the foot has been taken off the pedal — yet HIV remains a real problem.”
Regular HIV testing is an important intervention therefore, especially among those who are likely to be particularly at risk. These include gay men, people from African communities, anyone who has been sexually active in an area of the world where HIV is endemic, sex workers and those who share needles.
“The benefit of a test is that if you know you have HIV, you can access treatment and care that will keep you well. says Professor Anderson. “Effective treatment means that you are much less infectious. Also, if your test is negative you can continue to take measures to prevent HIV; and the more people who take HIV tests, the more common it becomes, and the more likely people are to begin to talk more openly about HIV. . It becomes a virtuous cycle.”
Testing can be carried out in a variety of ways: a simple blood test or mouth swab taken by a healthcare professional; self-testing kits (launched in April of this year); plus home finger-prick sampling (where you send a blood sample to a laboratory for analysis). If a test is positive, support is available, depending on how and where you chose to take your test. With the home sampling service, for example, you will be contacted by an HIV support group who will support you and ensure that you can quickly access the right HIV services. In healthcare settings, the majority of HIV testing takes place within sexually transmitted infection clinics, run by trained professionals used to supporting those with HIV. Online support and support from charities is also available.
In the UK, millions of HIV tests are carried out in sexually transmitted infection clinics every year, although numbers of tests in other settings — such as general practice — are harder to quantify. “In some healthcare environments, tests are not always offered when they should be — so there is a gap,” says Professor Anderson. “But anyone can ask for an HIV test wherever they feel most comfortable: with their GP, at a clinic or online, for example.”
In some parts of the world, awareness around HIV testing is more advanced than in the UK. “There is some really innovative practice in countries which have major HIV epidemics,” says Professor Anderson. “In parts of Africa, for example, there are community testing programmes which have much greater reach than we do here in the UK. But it should be noted that in the UK data shows that, among all those who are living with HIV, the proportion who are diagnosed is 83 per cent. In America it’s a similar number. That’s a good measure of how effective a country’s testing programme is.”
Overall, the message is don’t be afraid to get tested, says Professor Anderson. “Early intervention can make a big difference to your long term health and wellbeing. .”
Yet it’s important to remember that today’s effective, life-prolonging HIV treatments shouldn’t be a regarded as a green light for unprotected sex. “If you have HIV, it certainly complicates your life,” says Professor Anderson. “So if people are repeatedly putting themselves in risky situations and repeatedly getting negative test results, they might feel invulnerable. But they aren’t — so ‘practice safe sex’ is still a vitally important message to get across.”