Testing in areas with high HIV prevalence

In local areas where there is already a recognised high prevalence of diagnosed HIV infection, it is assumed that there will also be a high prevalence of undiagnosed infection. In these cases, it is recommended that HIV tests should be offered to all people who register at primary care services or who are admitted to hospital as inpatients.

The Health Protection Agency has analysed existing data on those attending HIV treatment and care services¹ (data come from the Survey of Prevalent HIV Infections Diagnosed, known as SOPHID) to identify those parts of the country where the HIV prevalence is high – in other words, where more than two people in 1000 have diagnosed HIV infection.

This is the case for 25 of the 31 primary care trust (PCT) areas in London, as well as areas such as Brighton & Hove and Manchester that have historically had high HIV prevalence. There are also areas which have experienced more recent increases in HIV prevalence such as Luton and Southend-on-Sea.

In total, 20% of the English population live in areas where universal opt-out testing is now recommended. However, given the novelty of this policy, the guidelines urge that the introduction of universal testing is thoroughly evaluated for acceptability and feasibility.

London PCTs where universal testing is recommended:

Barking and Dagenham, Barnet, Brent Teaching, Camden, City and Hackney Teaching, Croydon, Ealing, Enfield, Greenwich Teaching, Hammersmith and Fulham, Haringey Teaching, Hillingdon, Hounslow, Islington, Kensington and Chelsea, Lambeth, Lewisham, Newham, Redbridge, Southwark, Sutton and Merton, Tower Hamlets, Waltham Forest, Wandsworth, Westminster.

Non-London PCTs where universal testing is recommended:

Blackpool, Bournemouth & Poole, Brighton & Hove City, Heart of Birmingham, Leicester City, Luton, Manchester, Nottingham City, Salford.

The HPA also provides a list of local authority areas with a high HIV prevalence, although this prevalence is not found across the rest of the respective PCT area:

Slough, Reading, Eastbourne, Northampton, Southend-on-Sea, Harlow, Watford, Crawley.

These lists come from the HPA's analysis in 2008, and may be updated in the future (see http://www.hpa.org.uk/).