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These are interesting and changing times for health professionals when it comes to HIV medicine and care. There are now over 100 000 people living with HIV in the UK, with approximately 25% of people living with HIV not being aware of their diagnosis. Hundreds of people who have HIV, but are currently undiagnosed, are being seen every day by primary care and other medical clinics but are not being tested even though there may or may not be significant signs and risk factors of HIV infection. Primary care, and other medical settings, should therefore be at the forefront on initiatives in HIV testing in the community, however many general practitioners (GPs) and other non-specialists do not feel confident in this area of HIV testing, and up until recently HIV testing outside of specialist clinics has been at relatively low levels. This is possibly due to the historical ‘separation’ of HIV medicine from primary care and other specialties, anxiety about giving positive HIV results, concerns about confidentiality, and also uncertainty about methods and the process of testing. Most non-specialists feel they need more guidance and education in this field.
This excellent book fills that gap and will prove to be an essential guide and tool for other doctors who want a quick overview of HIV testing and diagnosis relevant for primary care and other non-specialists. It is concise, extremely well written and is pitched at just the right level for non-specialists, and discusses all aspects of HIV testing and diagnosis. There are helpful and well laid out chapters on HIV epidemiology; recommendations for and methods of testing, methods of diagnosis, pre- and post-test discussions, and also an extremely enlightening chapter on barriers to testing for HIV.
Dr Ann Sullivan, Dr Emma Devitt and Ruth Lowbury, in this second edition, skillfully demonstrate possible HIV presentations in a system- and symptoms-based approach using excellent case studies with photographs and useful summary boxes. The importance of recognising HIV seroconversion is emphasised, and there are also sections on testing for HIV in children, HIV and mental health and medico-legal aspects of HIV testing, such as testing the unconscious patient without consent. Chapter 8 also has a whole section on how to find out further information from other sources, with useful websites, organisations and charities.
As a GP with an interest in HIV testing and care, I highly recommend this essential guide for all one needs to know about this extremely important topic.