Letter from Heather Wilson, SHASTD president to BMA news review.

Dear Editor

Re: The BMA foundation for AIDS leaflet: ‘Take the HIV test’.

We are writing to widen the debate about this new leaflet. As Health Advisers working in Genito Urinary Medicine/ Sexual Health clinics we would like to support and encourage GP’s in raising and discussing the HIV test with their patients. Particularly for those patients where it is a differential diagnosis and, or those who are perceived to be at a higher risk of infection.

This leaflet plays down the difficulties for patients and GP’s testing in the GP setting e.g. the insurance implications, and dealing with a positive result. Complex medico legal issues are vastly over simplified or omitted.

The insurance issue is a complex one as GP’s find themselves with an obligation to the insurance company as an employer. Insurance companies are still asking GP’s questions relating to lifestyle and sexual health.
Even the question “when was the patient last seen and why?” can raise dilemmas. Insurance medicals are not done by family practitioners in other European countries. Is this the real issue that prevents testing and documentation of tests? If so can this be addressed by routinely offering testing, of course remembering that it will always be far more complex for those who are at risk or have HIV.

This leaflet also tries to re - stigmatise the GUM speciality. In GUM clinics ‘counselling’ is not compulsory prior to testing Doctors, nurses and health advisers all routinely offer and discuss the HIV test within the clinic setting as part of the sexual history taking and patient
assessment. Attendance at a clinic is not a barrier to testing and we do not regard counselling as a panacea. These statements, contained within the the leaflet are deeply innacurate and do not reflect the reality of the modern GU clinic. People do have difficulty discussing some risks with a family GP. In our experience attendance at an open access, confidential service can facilitate this discussion.

Yours sincerely

Heather Wilson BSocStud MSC Cert MHS
President Society for Health Advisers in STD