When HIV positive patients turn up at sexual health clinics, a significant proportion of those whose wellbeing is affected by the infection are not reporting it to NHS staff members. This is according to preliminary research published online in the journal Sexually Transmitted Infections, which, if reflective of a national trend, could indicate the true prevalence of undiagnosed HIV infection in the UK.
In this country, it’s currently estimated that one in four people’s wellness is affected by HIV without their knowledge. Experts base this estimate on several sources of data, including the GUMAnon Survey, which examines blood samples taken from patients to test for syphilis at one of 16 participating sexual health clinics across the UK, to look for signs of HIV. It is believed that even when people do know they are HIV positive, a proportion still do not to reveal it to NHS staff when attending for services elsewhere, hence the researchers investigated whether or not this was the case.
The researchers looked for the presence of very low viral loads – very low amounts of circulating virus, and a hallmark of successful drug treatments – and various antiretroviral drugs in all HIV positive samples from one participating GUMAnon clinic in London in 2009. 28 of the 130 samples which matched clinic records were from patients who were not known to be HIV positive before their arrival at clinic, ten of whom where then tested at their clinic visit. 72% of the remaining 18 ‘undiagnosed’ patients had very low viral loads, indicative of successful drug treatment.
According to the study’s authors, ‘This is the first published objective evidence that non-disclosure of HIV status as a phenomenon exists in patients attending [sexual health] clinics in the UK. Given the high proportion of individuals classified within this study as [non-disclosing], the extent to which these findings can be extrapolated to other clinics, and the degree to which they may influence estimates of the proportion of undiagnosed HIV in the community, warrants further study.’
Lead author Dr Ann Sullivan, of London’s Chelsea and Westminster Hospital NHS Foundation Trust, explained in an accompanying podcast that as HIV positive patients can attend many different sexual health clinics in London, it’s easier for them to keep quiet about their infection than in other parts of the country. They may not want to be ‘judged’, she suggested, because coming to a clinic with another infection means they may have indulged in risky sexual behaviour. However, Dr Sullivan added that these people could be putting their wellbeing at risk by not revealing their HIV status.
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Are a Significant Number of HIV Cases Going Unreported?
