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HIV in Primary Care

HIV in Primary Care

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HIV in Primary Care

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  1. HIV in Primary Care Justin Walker November 2011

  2. Learning Objectives • Know when to consider testing for HIV in primary care • To learn the best practice around testing • To know what topics should be covered in counselling • Symptoms and signs of primary HIV • Clinical conditions associated with long term HIV

  3. Programme • Introduction - HPA Annual Report 2011 • Small group work • Feedback within groups • Plenary • Question and answer session • Useful sources of information

  4. Introduction • By the end of 2010, approximately 91,500 people were living with HIV in the UK, of whom about 24% are undiagnosed. • 6,600 people were newly diagnosed with HIV • 50% of these were diagnosed late • These individuals have a tenfold increased risk of dying within a year of diagnosis, compared to those diagnosed promptly (4.0 vs 0.4%).

  5. Introduction • People living with diagnosed HIV can expect a near-normal life expectancy • An estimated 3000 new diagnoses in MSM, the highest ever • In 2010 one in seven overall and one in four MSM had recently acquired infection.

  6. Introduction • More than 2.1 million HIV tests were performed in 2010, most in STI clinic and antenatal settings. • Coverage in STI clinics 69% • Coverage in antenatal care 96%

  7. What’s Happening Locally?

  8. Areas to Cover • Primary HIV Infection and aetiology • Testing - who and when • Testing - practicalities and counselling • Clinical conditions associated with long term HIV.

  9. Small Group Work • Split into groups of four • Review resources (10-20 mins) • Present summary to other members of the group. Note any questions. (30 mins) • Tea, coffee and lots of cake • Plenary, question and answer session. • Sources of information.

  10. Herpes zoster

  11. Rash in primary HIV infection

  12. Kaposi’s sarcoma

  13. Kaposi’s sarcoma II

  14. Sebhorrhoeic dermatitis

  15. Oral candida

  16. Oral hairy leukoplakia

  17. Palatal kaposi’s sarcoma

  18. Plenary • Primary HIV Infection and aetiology • Testing - who and when • Testing - practicalities and counselling • Clinical conditions associated with long term HIV.

  19. Key Recommendations I • In high HIV prevalence areas universal HIV testing should take place for all general medical admissions and new registrants in general practice. • HIV testing in STI clinics should be universal.

  20. Key Recommendations II • People most at risk of HIV infection (MSM, black Africans, IVDUs) should have an annual HIV test • People with HIV should have PCV13 to decrease incidence of invasive pneumococcal disease.

  21. Useful Sources of Information • Managing HIV in Primary Care - MedFASH • HIV Annual Report 2011 - HPA • Recommendations for HIV testing 2008 BHIVA • www.hiv-druginteractions.org