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Call for HIV testing in casualty Call for HIV testing in casualty
(about 4 hours later)
A hospital consultant is calling for widespread HIV testing for accident and emergency department patients.A hospital consultant is calling for widespread HIV testing for accident and emergency department patients.
Dr Kaveh Manavi, a consultant in HIV medicine at Birmingham's Selly Oak Hospital, told the BBC everyone should be tested unless they opted out.Dr Kaveh Manavi, a consultant in HIV medicine at Birmingham's Selly Oak Hospital, told the BBC everyone should be tested unless they opted out.
He said the current system, which targets high-risk groups, such as gay men and drug users, missed many people.He said the current system, which targets high-risk groups, such as gay men and drug users, missed many people.
HIV charity the Terrence Higgins Trust says targeted testing by GPs and clinics would be more cost effective.HIV charity the Terrence Higgins Trust says targeted testing by GPs and clinics would be more cost effective.
Late diagnosisLate diagnosis
Dr Manavi told BBC Radio Five Live the current testing system failed to pick up many adults outside the key targeted groups who were at risk of infection.Dr Manavi told BBC Radio Five Live the current testing system failed to pick up many adults outside the key targeted groups who were at risk of infection.
He said studies suggested a fourth of patients infected with HIV were diagnosed late and that the target-based HIV tests were not tackling these figures.He said studies suggested a fourth of patients infected with HIV were diagnosed late and that the target-based HIV tests were not tackling these figures.
"Target-based HIV tests - offering the test to intravenous drug users and gay men - is not going to work because individuals may not identify themselves as a risk," he said."Target-based HIV tests - offering the test to intravenous drug users and gay men - is not going to work because individuals may not identify themselves as a risk," he said.
The sooner an individual is diagnosed with HIV, the higher their likelihood of a better prognosis Dr Kaveh ManaviThe sooner an individual is diagnosed with HIV, the higher their likelihood of a better prognosis Dr Kaveh Manavi
"All the current data suggests a large proportion of patients, in the UK at least, are heterosexual, so we will miss a proportion of HIV-infected patients.""All the current data suggests a large proportion of patients, in the UK at least, are heterosexual, so we will miss a proportion of HIV-infected patients."
Dr Manavi wants to see wider screening so that more patients are diagnosed early.Dr Manavi wants to see wider screening so that more patients are diagnosed early.
They could then be offered better treatment as well as given the option of altering their behaviour to cut the risk of passing on the virus, he said.They could then be offered better treatment as well as given the option of altering their behaviour to cut the risk of passing on the virus, he said.
'Better prognisis''Better prognisis'
Such widespread screening is already carried out on pregnant women who are routinely checked to reduce the risk of passing on the virus to their babies.Such widespread screening is already carried out on pregnant women who are routinely checked to reduce the risk of passing on the virus to their babies.
"Early diagnosis of HIV has got advantages for patients," said Dr Manavi."Early diagnosis of HIV has got advantages for patients," said Dr Manavi.
"It will prevent them from developing AIDS and it will prevent them from transmitting infection to other individuals.""It will prevent them from developing AIDS and it will prevent them from transmitting infection to other individuals."
He added: "The sooner an individual is diagnosed with HIV, the higher their likelihood of a better prognosis."He added: "The sooner an individual is diagnosed with HIV, the higher their likelihood of a better prognosis."
But the Terrence Higgins Trust, said it would be "much more useful" if GPs and family planning clinics conducted the tests because they had a "better idea of whether their patients are sexually active". But the Terrence Higgins Trust, said that rather than blanket-testing, it would be much more useful if GPs and family planning clinics conducted the tests because they had a "better idea of whether their patients are sexually active".
Lisa Power, the charity's head of policy, said: "It is much more useful to do that, otherwise, the number of people you are offering it to - to whom it is irrelevant - actually makes it not cost effective offering the tests." Lisa Power, the charity's head of policy, said: "We don't disagree with this doctor about the need to better diagnose HIV.
"We're just questioning whether blanket testing in accident and emergency would be the best way of spending the limited amount of money that the NHS has."
One person in three who are HIV do not know they have the virus while others who have been at risk refuse a test because of the stigma associated with the virus, said Ms Power.
She said ways other than blanket-testing needed to be found to tackle these issues.