We were interested to read the article by Glew and colleagues on opt-out testing for HIV.1 In 2009, our team demonstrated the feasibility and acceptability of opt-out point-of-care (POC) HIV testing in general practice. Building on these data we have undertaken a cluster randomised controlled trial of opt-out POC HIV testing in primary care. In the RHIVA2 trial, all general practices in Hackney were invited to take part.2 Forty of 45 practices were randomised to either intervention (testing) or control (usual care). Intervention practices received education and training to promote and deliver opt-out POC HIV testing to new registrants. The trial data are very encouraging. We observed a POC testing uptake of 45% (4978 of the 11 180 rapid tests offered were accepted). Intervention practices identified more patients with newly diagnosed HIV than control practices. Furthermore, patients in the intervention practices were diagnosed with higher baseline CD4 counts than in the control group.
We recommend that HIV testing be introduced in UK general practices located in high HIV prevalence areas.
REFERENCES
- 1.Glew S, Pollard A, Hughes L, Llewellyn C. Public attitudes towards opt-out testing for HIV in primary care: a qualitative study. Br J Gen Pract. 2014 doi: 10.3399/bjgp14X677103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Leber W, McMullen H, Marlin N, et al. Point-of-care HIV testing in primary care and early detection of HIV (RHIVA2): a cluster randomised controlled trial [conference abstract] Lancet. 2013;382:S7. [Google Scholar]