New GP approach aims to boost HIV testing and prevention

A new initiative could transform how HIV is diagnosed and prevented in UK general practice, according to a National Institute for Health and Care Research (NIHR) funded study published in the British Journal of General Practice.

Researchers at the NIHR Applied Research Collaboration (ARC) West and University of Bristol have developed a strategy called PATH-GP (Prevention and Testing for HIV in General Practice). It aims to help more people get tested for HIV and improve access to PrEP – a tablet that prevents you getting HIV, available for free via NHS sexual health clinics.

The development of PATH-GP comes as the UK government works toward its goal of ending new HIV transmissions by 2030. Despite regular contact with primary care, many people living with undiagnosed HIV are not tested until the disease has significantly progressed. Earlier diagnosis is crucial, as those who begin treatment early can live a normal lifespan and cannot pass on the virus once it is suppressed to undetectable levels.

Our research found that GP staff often lacked knowledge about HIV, had concerns about the cost and time required for HIV testing, and lacked systematic ways to test. Awareness and knowledge about PrEP was low among GP healthcare professionals.

The PATH-GP approach was co-created with patients, GPs, nurses and healthcare commissioners. It is based on evidence, behavioural science and real-world clinical insight. It includes:

• Training for GP staff on HIV and PrEP
• ‘Opt-out’ HIV testing in certain clinical scenarios
• A digital reminder system to flag patients who may benefit from a test
• Improved patient information
• A designated “champion” in each practice to support the programme

Dr Anne Scott, lead author of the study, explained:

“Our project developed a new way of increasing HIV testing and access to PrEP. We found multiple challenges to HIV testing and supporting access to PrEP. To address these, an approach with several parts is needed.”

Dr Sarah Denford and Dr Jo Kesten, project co-leads, added:

“We’re excited to see this new approach published. The next step is to obtain funding to test if PATH-GP works. If it does, it may help achieve the goal of eliminating new HIV cases by 2030.”

The study was funded by the NIHR School for Primary Care Research and carried out by researchers from NIHR ARC West, the NIHR Health Protection Research Unit in Evaluation and Behavioural Science and the Centre for Academic Primary Care at the University of Bristol.