Letter from Heather
Wilson, SHASTD president to BMA news review.
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
GPs 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 GPs 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 GPs find themselves with an obligation to
the insurance company as an employer. Insurance companies are still asking GPs
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.
Heather Wilson BSocStud MSC Cert MHS
President Society for Health Advisers in STD