Patients are willing to undergo a routine HIV test at their practice, a pilot study has demonstrated.

Patients aged 18-55 attending an inner London practice for a new patient registration check were recruited into the study. All eligible patients were offered a rapid HIV test on oral fluid and asked to participate in a semi-structured interview on the pros and cons of testing for HIV in primary care. Out of 85 eligible patients, 47 took part in the study and 20 completed qualitative interviews.

Nearly half (38/85) of eligible participants accepted a rapid HIV test. People from black African and Caribbean groups were more likely to accept the test compared with those from other ethnic backgrounds.

All the patients who were interviewed felt that rapid HIV testing in general practice was appropriate and identified several benefits:

• shorter wait for test results

• more accessible than GUM clinics

• the test seems more routine and normal.

However, the disadvantages stated include:

• lack of support for newly diagnosed HIV cases

• not feeling prepared to be tested on the spot

• reservations about accuracy of test.

A third of those interviewed thought the new patient check was a suitable time for the test but some felt it should be initiated by either the patient or the doctor.

It appears rapid HIV testing in general practice is acceptable to many patients, especially at a routine check up and particularly among black African and Caribbean populations.

According to a Health Protection Agency report, published in 2008, a quarter of the 77,400 adults currently living with HIV in Britain are unaware of their infection; this puts their sexual partners at risk and further increases HIV transmission. An audit by the British HIV Association in 2003 found that many patients are diagnosed at a late stage of illness when antiretroviral drugs are less effective and have a poorer prognosis. Current UK national guidelines recommend an increase in HIV testing in primary and secondary care settings to improve early diagnosis.

However, I think for this to be successfully rolled out in primary care, there need to be adequate incentive structures in place to encourage uptake, and effort should be concentrated in areas of high HIV prevalence such as London, Brighton and other urban areas.