Quality statement 5: People who may have been exposed to HIV

Quality statement

People who may have been exposed to HIV by a person newly diagnosed with HIV are offered an HIV test.

Rationale

People who may have been exposed to HIV by a person newly diagnosed with HIV are at high risk of being infected. Identifying and contacting these people will enable them to be offered an HIV test as soon as possible. Early diagnosis of HIV improves treatment outcomes and reduces the risk of transmission to other people.

Quality measures

Structure

Evidence of local arrangements to ensure that notification procedures are in place to identify people who may have been exposed to HIV by a person newly diagnosed with HIV. These arrangements may include referral pathways to specialist sexual health services.

Data source: Local data collection, for example, service protocol and referral pathways.

Process

Proportion of contactable people who may have been exposed to HIV by a person newly diagnosed with HIV who are tested within 3 months.

Numerator – the number in the denominator who are tested for HIV within 3 months.

Denominator – the number of contactable people who may have been exposed to HIV by a person newly diagnosed with HIV.

Data source: Local data collection, for example, an audit of patient health records.

Outcome

a) Number of people tested per total number of index cases.

Data source: Local data collection, for example, an audit of patient health records.

b) Number of new HIV diagnoses.

Data source: Local data collection for Public Health England's HIV and AIDS reporting system.

c) Number of new HIV diagnoses made at a late stage of infection.

Data source: Local data collection for Public Health England's HIV and AIDS reporting system. Late stage of infection is defined as a CD4 count less than 350 cells per mm3.

What the quality statement means for different audiences

Service providers (such as sexual health clinics) have processes in place to ensure that people who may have been exposed to HIV by a person newly diagnosed with HIV are identified and offered an HIV test.

Healthcare professionals (such as sexual health advisers) help people who test positive for HIV to identify people who they may have exposed to HIV using standard notification procedures. Once people who may have been exposed to HIV are identified, healthcare professionals make contact with them to offer an HIV test.

Commissioners (such as local authorities) commission services that ensure that people who may have been exposed to HIV by a person newly diagnosed with HIV are identified and offered an HIV test.

People who may have been exposed to HIV by a person newly diagnosed with HIV are contacted and offered an HIV test. This will ensure that, if they also have HIV, they are diagnosed and treated as early as possible.

Source guidance

Definitions of terms used in this quality statement

People who may have been exposed to HIV by a person newly diagnosed with HIV

Potential routes of HIV exposure include sexual, injecting drug use and other (including blood/blood product transfusion, organ and skin transplantation, semen donation, and needlestick and other injury). It does not include vertical transmission of HIV from mother to baby that is identified by universal antenatal screening.

[Adapted from HIV partner notification for adults: definitions, outcomes and standards British HIV Association]