This week is National HIV Testing Week, when people at high risk of HIV are encouraged to get tested to protect their own health and make them less likely to unknowingly pass the virus on to their sexual partners.
The benefits of testing
In the UK, an estimated 103,700 people are living with HIV, with around 17% (18,100) people unaware of their infection.
We know that regular testing is essential to winning the fight against HIV, and this is especially true for those most at risk, such as gay and bisexual men and other men who have sex with men, and men and women in black African communities.
HIV treatment can be so effective that those who are diagnosed early can often expect to have the same life expectancy as someone who is HIV-free – people with HIV can live long and healthy lives. And once someone with HIV starts treatment, this greatly helps to reduce their potential infectiousness (as the drugs reduce the viral load in the body). Increasing HIV testing is therefore a key prevention strategy.
Cost effectiveness of early diagnosis
Testing regularly can help to improve rates of early diagnosis, which not only has major individual and public health benefits but also ultimately reduces the burden on the NHS and care services. Early diagnosis shrinks the cost of care as prompt treatment prevents further infections and reduces the need for treatment in hospital.
In the UK, the annual cost of late treatment is estimated to be 22% higher compared with the cost of treatment at an early stage.
In order to realise the full benefits of testing for HIV, we need to improve access to testing outside of traditional clinics, reaching out to those who may not usually engage with their local sexual health service.
HIV home-sampling
HIV home-sampling kits allow individuals to take a sample themselves at home by taking a finger-prick blood test.
Unlike home-testing kits, where the individual receives an immediate result, this sample is then sent to a local laboratory for HIV testing and importantly, specialist management.
If a person is identified as having HIV, they will be contacted within 5 working days and given support options and information on where to go to get specialist service. Those with a negative result will be contacted and informed within 3 days, or they can log in online using their unique personal code to check their results.
Home-sampling complements existing HIV testing services by offering an alternative, and provides major cost savings in three key areas:
- cutting the cost of treatment through early diagnosis;
- increasing the capacity for testing without major investment in existing services; and
- lowering the cost of HIV testing – self-sampling requires far lower resource than current testing services.
Public Health England piloted innovative HIV home-sampling services (also called self-sampling) that offered an alternative way for high-risk groups to get tested for HIV.
The pilots enabled large numbers of people from the most at-risk populations to test quickly and easily, and also reached significant proportions of people who had never tested before. Now, we’ve moved from a pilot to a sustainable home-sampling service for high-risk groups nationwide.
A national HIV home-sampling service has been co-commissioned by PHE and 89 participating local authorities, and is now up and running. We are currently funding the distribution of home-sampling kits for those most at risk of acquiring HIV infection in support of National HIV Testing Week, and these can be requested online at freetesting.hiv
We want to engage and target high-risk groups and increase HIV testing among those who do not regularly attend sexual health services and we will evaluate use of the service to make sure we are reaching those who are most at risk. In the first week since the service launched, 7,500 kits have been requested by people at high-risk of acquiring HIV and 223 tests have been carried out.
Taking action
The HIV self-sampling service is there to support the great work that is already being done at a local level to target at-risk groups. At PHE, we have a wealth of data that can help local authorities identify these groups in their areas.
Individuals most at risk of infection can access a free HIV self-sampling kit at freetesting.hiv. Alternatively, you can ask your GP for an HIV test or go to a sexual health clinic. HIV charities also offer free, confidential and open-access services.
Commissioners and health care providers are crucial part of this service. The campaign message for National HIV Testing Week is ‘It starts with me’ - you can get involved and take advantage of the fantastic resources available to promote HIV testing services near you.