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Guidance on HIV Indicator conditions (OptTEST)

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Guidance on HIV Indicator conditions (OptTEST)

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Dr Emily Lord: How to Enhance Provider Initiated HIV Testing (OptTEST)

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Dr Emily Lord: How to Enhance Provider Initiated HIV Testing (OptTEST)

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CHIP. Health & Infectious Disease Research

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CHIP. Health & Infectious Disease Research

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Dr Emily Lord: How to Enhance Provider Initiated HIV Testing (OptTEST)

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HIV Indicator Condition Testing in a hospital setting: 2023

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HIV Indicator Condition Testing in a hospital setting: 2023

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Quality statement 3: HIV indicator conditions

Quality statement 3: HIV indicator conditions

Quality statement

Young people and adults newly diagnosed with an HIV indicator condition are offered an HIV test.

Rationale

Increasing the uptake of HIV testing among people who may have been infected is important to reduce late diagnosis. Early diagnosis improves treatment outcomes and reduces the risk of transmission to other people. Offering HIV testing in primary and secondary care to people newly diagnosed with conditions that may indicate HIV infection could mean that potentially serious consequences of HIV infection are avoided. It may also improve response to treatment for the indicator condition.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence of local systems that alert healthcare professionals to the need to offer an HIV test when an indicator condition is diagnosed.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from system specification.

b) Evidence of local processes to offer an HIV test to young people and adults newly diagnosed with an indicator condition.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from service protocols.

Process

Proportion of young people and adults newly diagnosed with an indicator condition who receive an HIV test.

Numerator - the number in the denominator who receive an HIV test.

Denominator - the number of young people and adults newly diagnosed with an indicator condition.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from an audit of patient health records.

What the quality statement means for different audiences

Service providers (such as hospitals including outpatient departments, general practices and sexual health services) ensure that staff are trained to offer and recommend an HIV test to young people and adults who are newly diagnosed with an indicator condition. Providers ensure that systems are in place to alert healthcare professionals to the need to offer and recommend an HIV test when a relevant diagnosis is made. Providers could offer an HIV test by an opt-out testing system.

Healthcare professionals (such as clinicians, GPs and nurses) offer and recommend an HIV test to young people and adults with HIV who are newly diagnosed with an indicator condition. If the test is declined, healthcare professionals should provide information on how to access other local HIV testing services.

Commissioners (such as integrated care systems, local authorities, clinical commissioning groups and NHS England) include HIV testing in the service specification for hospitals and GP practices. Commissioners ensure that providers have processes in place to offer and recommend an HIV test to all young people and adults who are newly diagnosed with an indicator condition.

Young people and adults with a health condition that may suggest they have HIV are offered an HIV test. This is so that they can be diagnosed and treated as early as possible if they are infected.

Definitions of terms used in this quality statement

Young people and adults

Young people are aged 16 and 17 years. Adults are aged 18 years and over. [Expert opinion]

HIV indicator conditions

HIV testing is recommended as identified in HIV in Europe's guidance on HIV indicator conditions. Service providers may wish to focus on the following priorities:

Potentially AIDS-defining conditions

Neoplasms:

Bacterial infections:

Viral infections:

Parasitic infections:

Fungal infections:

Conditions in which the prevalence of undiagnosed HIV is more than 0.1%

Conditions likely to have an undiagnosed prevalence of HIV of more than 0.1%

Conditions likely to have an estimated prevalence of HIV lower than 0.1% but where not identifying HIV infection may have significant adverse implications for the person's care

[ HIV in Europe's guidance on HIV indicator conditions]

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This quality standard covers interventions to improve the uptake of HIV testing among people who may have undiagnosed HIV. It focuses on increasing testing to reduce undiagnosed infection in people at increased risk of exposure. It describes high-quality care in priority areas for improvement

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Evaluation of HIV testing: Indicator conditions

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Evaluation of HIV testing: Indicator conditions

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Improving IC guided testing for HIV: 2022

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Improving IC guided testing for HIV: 2022

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OptTEST Tools

The OptTEST by EuroTEST project - Optimising testing and linkage to care for HIV across Europe - was a three-year project co-funded by the EU Commission under the Second Health Programme. The project aimed at helping to reduce the number of undiagnosed people with HIV infection in the European region and at promoting timely treatment and care. The project produced tools and assessment methods to analyze and effectively respond to late presentation for HIV care and treatment, with a particular emphasis on priority regions and groups throughout Europe. The tools are presented below.
Introduction to indicator condition (IC) guided testing:
Indicator condition (IC) based testing is an effective and efficient strategy within healthcare settings to expand HIV testing and more timely diagnosis. This is an approach where healthcare professionals routinely offer an HIV test to all individuals presenting with an indicator condition because the condition is associated with undiagnosed HIV infection. We created a slide set about late testing, barriers to testing and IC guided testing strategy that can be used to present the concept of IC guided testing to a range of audiences, e.g. decision makers.

Download the slide set "Introduction to IC guided testing" in English - French - Estonian - Polish - Russian - Spanish

"Instructions" slide set can be used by HIV clinicians and specialists in other fields who manage indicator conditions to make presentations about HIV testing to a range of audiences, e.g. decision-makers, with particular reference to the introduction of indication condition guided HIV testing.

Download the slide set "Instructions" in English - French - Estonian - Polish - Russian - Spanish
E-learning module:
As a part of OptTEST the module for non-HIV specialist healthcare professionals was developed. It aims to support providing HIV testing for people with HIV indicator conditions.

To start learning follow the link: IC guided testing for non-HIV specialist healthcare professionals
Online planning tool:
This resource has been developed for lead clinicians or managers who are planning to introduce indicator condition guided HIV testing in their service. It will show the operational points that should be considered while planning to start testing in the service. It will help to consider what will happen before an HIV test is offered, how testing will be done and how results will be managed.

Go to the tool: How to set up IC guided testing in a clinic

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OptTEST Tools The OptTEST by EuroTEST project - Optimising testing and linkage to care for HIV across Europe - was a three-year project co-funded by the EU Commission under the Second Health Programme. The project aimed at helping to reduce the number of undiagnosed people with HIV infection in the European region and at promoting timely treatment and care.