Testing of patients and blood donors

        Tests for anti-HIV-1 and -2, HIV-1 antigen and HIV-1 genome are widely available in the UK. Anti-HIV tests are carried out daily in most public health laboratories and in blood transfusion centres. The facilities in transfusion centres emphatically do not exist to provide testing for those at risk, however. The primary means by which the blood supply is protected from contamination with HIV is through those individuals at increased risk of HIV infection refraining from volunteering to give blood.

      Those who wish to be tested for anti-HIV should instead consult their general practitioner or attend a sexually transmitted diseases (genitourinary medicine) clinic, where the advisability of HIV testing can be discussed. If a decision to test is made the necessary investigations are readily and freely available. In some localities “open access” facilities exist to encourage self-referral for counselling and testing. Other innovations, such as home testing on the patient’s own initiative, are being considered in the USA and might be introduced into the UK.

     As testing becomes more common, and as kits with which people can test themselves are now technically feasible and might be introduced in the future, it is important to be aware of the psychological impact of test findings on those who are tested. While the emergence of effective drug treatment for HIV carriers makes testing for anti-HIV desirable for those who think they may have been put at risk, there should remain an element of medical supervision to respond to patients’ questions and anxieties. Telephone helplines have been proposed to provide this support.