UK guidelines

British HIV Association (BHIVA) testing guidelines recommend that testing should be considered if a person has symptoms of seroconversion and is perceived to be at risk of infection. The guidelines acknowledge the difficulties of discussing sexual risk in many medical settings, but suggest that the threshold for offering a test should be low.

Fourth-generation tests are recommended. They are thought to be able to detect most cases approximately 14 to 16 days after infection.

Nonetheless very recent infections may still be missed because of the test’s window period. If the initial result is negative but primary infection is suspected, the guidelines recommend either:

• Urgent referral to a specialist GUM or HIV service for advice and possible use of viral load testing, or
• Repeat testing after seven days.¹

Other organisations have suggested that people with suspected recent infection should be encouraged to abstain from sex while waiting for definitive test results.²