Enhancing HIV testing in GP practices and pharmacies in a region of disparate prevalence: An MDT approach

Background: Locations within the Hampshire and Isle of Wight catchment high prevalence rates for HIV infection and between 34 and 74% of HIV infections are diagnosed 'late'(CD4 <350) across this region between 2017-19. GP practices and community pharmacies provide clinician-led opportunities for testing based on local HIV rates and/ or indicator conditions that may present to them. However, practice varies across the patch and there are dynamic areas of varying HIV prevalence within, which can make the provision of area-specific resources challenging. Method: Solent NHS regional HIV services set up a task group of selected professionals to devise a strategy to improve GP and pharmacists' understanding and confidence in offering HIV testing with a longer-term view to increasing testing regionally outside a sexual health setting. 2 HIV pharmacists, an HIV consultant physician, a sexual health promotion practitioner and network and communications manager met to consider their experiences of HIV testing among GPs and community pharmacy sector across the diverse region. The following narratives were explored: community dispensing pharmacy experience;local enhanced pharmacist training pathways competencies;outcomes of GP investigations following late HIV diagnosis incidents;recent GP exercises to identify patients requiring COVID shielding letters;and clients' perspectives and outcomes of past health promotion and HIV testing efforts. Results: The study MDT produced free GP and pharmacist HIV testing resources (www.letstalkaboutit.nhs.uk/ hivinfo) including training packages, bespoke testing options, and pathways into specialist services (to be detailed on poster). The resource was shared with regional CCGs and the Community Pharmacy South Central to be cascaded to GPs and pharmacists in time for HIV testing week 2021 (to be used all year round). Regional HIV specialists agreed to share this document with GPs following late HIV diagnosis look-backs. Conclusion: The team's in-depth understanding of local communities and variation in practices enabled the production of a tailored resource to develop non-HIV professionals by addressing barriers and build confidence in offering tests. By collating prevalence recommendations, indicator conditions and risk stratification tools, this pack can be used by professionals in low and high HIV prevalence alike.