Opt-out HIV testing in emergency departments: learning from the experience of two London trusts

With the launch of the Government’s HIV Action Plan, England has set a target to reduce new HIV transmissions by 80% by 2025, and end them by 2030.

To support these ambitions NHS England and Improvement are expanding opt-out testing in emergency departments (ED) in the highest prevalence local authority areas, a proven effective way to identify new cases, by investing £20m over the next three years to support this activity.

We’ve worked with the Elton John AIDS Foundation to produce new guidance for NHS hospital trusts looking to implement opt-out ED HIV testing.

The Elton John AIDS Foundation (EJAF) Zero HIV Social Impact Bond (SIB) was a world-first initiative when it launched in 2018, aimed at focusing on bringing individuals with HIV into care across the South London boroughs of Lambeth, Southwark, and Lewisham.

EJAF, Lambeth Council, The National Lottery Community Fund, ViiV Healthcare, Comic Relief and Big Issue worked in partnership to deliver the SIB with local organisations and health systems, including local NHS hospital trusts.

The Zero HIV SIB operates across three settings: in hospitals, in GP surgeries and in the community.

Front page of briefingThis new resource outlines practical guidance learned from the SIB, focusing on ED HIV testing initiatives at King’s College Hospital NHS Foundation Trust and Lewisham and Greenwich NHS Trust.

The guidance includes:

  • Top tips from ED and HIV clinic teams.
  • Learning from the Zero HIV SIB.
  • Case study on implementing HIV testing in ED settings.
  • Practical examples of tools and advice, including processes of communicating HIV test results.

Download guidance [pdf]

Further resources

Fast-Track Cities London is working with NHS England and partners to support the roll out of HIV, hepatitis C and hepatitis B testing in London emergency departments.

It has produced a best practice guide for clinicians and NHS hospital colleagues: Blood-borne viruses opt-out testing in emergency departments in London [PDF]

Shigella trends in England – webinar recording

In April, HIV Prevention England hosted a webinar with colleagues from the UK Health Security Agency (UKHSA) and the British Association for Sexual Health and HIV (BASHH). You can watch a video of the webinar below.

Colleagues will be aware that surveillance by the UKHSA has detected a rise in cases of extremely antibiotic-resistant Shigella sonnei infections, mainly in gay, bisexual, and other men who have sex with men (MSM).

Shigella consists of bacteria that cause intestinal infection resulting in symptoms ranging from mild to severe (including diarrhoea, fever, and abdominal pain). In most cases symptoms subside within a week, but some individuals need hospitalisation and require intravenous antibiotic treatment.

Transmission occurs via the faecal-oral route through direct contact with an infected person, or exposure to contaminated surfaces, food or water. In the UK cases are increasingly via sexual transmission (direct oral-anal contact, oral sex after anal sex or play, including fingering or use of sex toys).

Your contribution is very important in helping us to recognise cases and raise awareness of how shigella is transmitted.

Shigella webinar recording

The webinar provided a short ten minute presentation, followed by a detailed Q&A discussion with a panel of experts from UKHSA and BASHH.

The video of the webinar below covers:

  • ‘Maybe it’s shigella’ campaign resources and information for patients
  • Brief introduction to shigella
  • Update on epidemiology of sexually transmitted shigella in England
  • Update on outbreak of extensively-drug resistant Shigella sonnei
  • Q&A discussion

Resources

Download the webinar slides: Shigella trends in England (UKHSA) [PDF]

Find out what patient resources and information are available.

Maybe It’s Shigella resources and webinar

Bad case of diarrhoea? Maybe it's shigellaHIV Prevention England is hosting an upcoming shigella webinar and providing free shigella posters and leaflets, as well as links to further information relevant to the public, patients and health care professionals.

Your contribution is very important in helping us to recognise cases and raise awareness of how shigella is transmitted.

Please cascade these resources among your networks.

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