GPs and primary care professionals

HIV testing in Primary Care

An estimated 4700 people are living with undiagnosed HIV in the UK according to the latest data from UKHSA. Increasing opportunities, including in Primary Care, to test for HIV is essential to ensure timely diagnosis, access to treatment and for prevention of onward transmission of HIV.

139,000 HIV tests were carried out in primary care in 2023, making GPs a crucial part of the England’s testing infrastructure. England still faces a challenge of late diagnosis of HIV with 41% of people diagnosed in 2023 at a late stage of infection.

When should GPs offer and recommend an HIV test?

Recommendations for when as a GP you should offer and recommend HIV testing varies by the diagnosed HIV prevalence in your local area. The diagnosed HIV prevalence measures the number of people aged 15 to 59 years seen at HIV services in the UK, expressed as a rate per 1,000 population.  The UKHSA stratifies prevalence into three categories;

  • Low prevalence – less than 2 people per 1000
  • High prevalence – 2-5 people per 1000
  • Very high prevalence – >5 people per 1000

You can check your local diagnosed HIV prevalence on UKHSA’s Sexual and Reproductive Health Profiles on Fingertips.

The table below outlines when to offer and recommend an HIV test.

Any prevalenceHigh prevalenceVery high prevalence
• has symptoms that may indicate HIV or HIV is part of the differential diagnosis
• is known to be from a country or group with a high rate of HIV infection
• reports sexual contact (either abroad or in the UK) with someone from a country with a high rate of HIV
• if male, discloses that they have sex with men, or is known to have sex with men, and has not had an HIV test in the previous year
• is a trans woman who has sex with men and has not had an HIV test in the previous year
• is diagnosed with, or requests testing for, a sexually transmitted infection
• discloses high-risk sexual practices, for example the practice known as ‘chemsex’
• reports a history of injecting drug use
• discloses that they are the sexual partner of someone at high risk of HIV		• Someone registers with the practice or
• is undergoing blood tests for another reason and has not had an HIV test in the previous year.		• Someone registers with the practice or
• is undergoing blood tests for another reason and has not had an HIV test in the previous year.
• consider HIV testing opportunistically at each consultation (whether bloods are being taken for another reason or not), based on clinical judgement.

National HIV Testing Week 2025

National HIV Testing Week is taking place 10-16 February 2025, helping to promote regular testing in England. This is a great time to remind yourself as a GP when to offer test patients for HIV.

Download our briefing for NHTW and primary care with five key messages to get you thinking about doing HIV tests in your clinical practice:

Other ways you can support National HIV Testing Week: