Primary Care HIV Toolkit

Why this matters in General Practice

Late diagnosis remains common and is associated with avoidable morbidity and mortality; national surveillance shows a substantial proportion of adults are still diagnosed late (CD4 <350) despite overall progress towards 95-95-95. Primary care is critical to closing this gap.

England’s HIV Action Plan 2025-2030 prioritises Prevent, Test, Treat, Thrive, Collaborate- with explicit expectations on scaling up testing, expanding digital access, supporting workforce development, and tackling stigma and inequalities.

Opt out testing in urgent care is working and demonstrates unmet need in local populations- GP teams can extend this momentum by normalising testing in primary care.

Clinical guidance & practical tools for HIV testing and prevention

Testing: who, when, and how (primary care–adapted)

Offer and recommend an HIV test when:

Indicator conditions or symptoms are present (e.g. STI diagnosis, hepatitis B/C, TB, lymphoma, mononucleosis like illness), as per BHIVA/BASHH HIV Testing Guidelines. LINK HERE

Increased risk by exposure or community prevalence (e.g. GBMSM, Black African communities, partners of PLHIV, people who inject drugs), or after PEP use.

Test type & window period

Use a 4th generation laboratory HIV Ag/Ab test; window period 45 days post exposure (earlier if acute illness-repeat if negative).

Frequency

Annual for people at ongoing risk (more often depending on exposure), consistent with BHIVA guidelines.

Results management

Reactive screening - urgent confirmatory algorithm, same day linkage to HIV services.

If acute retroviral syndrome is suspected with a negative/indeterminate result, repeat testing and consider HIV RNA/viral load testing via specialist advice.

Referrals :: Hampshire and Isle of Wight Healthcare Sexual Health

PREVENTION

PrEP and PEP in Primary Care

PrEP (pre exposure prophylaxis)

Who: Anyone HIV negative at significant risk should be offered PrEP; UK guidelines emphasise equity and easier dosing for all populations (including women, trans and non binary people).

How: PrEP can be commenced in Sexual Health Services. 

Patients are given oral tablet- Tenofovir/Emtricitabine. Event based dosing, daily dosing and quick start double dose options will be discussed with the patient in sexual health services.

Primary Care support: General Practice should identify need, signpost, and support ongoing care (e.g. kidney monitoring when advised by specialist). 

 https://www.letstalkaboutit.nhs.uk/hiv-services/hiv-prep

Patient education: https://rebrand.ly/PrEPLeaflet

Resources for Professionals on eligibility, access and local prescribing pathways can be found at  HIV - PrEP :: Hampshire and Isle of Wight Healthcare Sexual Health

PEP (post exposure prophylaxis)

Urgent (within 72 hours) via sexual health/ED if significant risk exposure. Ensure information & signposting are embedded in GP triage protocols; consider transition to PrEP if risk persists.

Treatment overview (for GP awareness)

All people diagnosed with HIV should start ART promptly, irrespective of CD4 count, to improve health and prevent transmission (U=U).

BHIVA 2022 ART guidelines (with 2025 interim update) outline first line regimens and monitoring- useful for medication reconciliation, interactions, vaccinations, and comorbidity care in GP.

 Useful Resources

The resource links below provide practical support to aid the early identification, testing, and management of HIV in primary care.

Clinical features | Diagnosis | HIV infection and AIDS | CKS | NICE - Evidence‑based clinical guidance from NICE on recognising the signs, symptoms, and diagnostic considerations for HIV, supporting accurate and timely assessment in primary care:

These guides within the link below support GPs in having clear, confident, and sensitive conversations with patients about HIV testing, prevention, and care:

HIV services :: Hampshire and Isle of Wight Healthcare Sexual Health – Our hub for HIV information explaining what our service offers and referral pathways.

NHS England » HIV prevention - National guidance summarises key HIV prevention strategies and priorities, enabling GPs to align their practice with current NHS England recommendations.

 Sexual and Reproductive Health Profiles - Data | Fingertips | Department of Health and Social Care – Localised data showcasing HIV prevalence.

 

Latest news

​​​​​​​Announcements

Upcoming events

Education and Training

 

Keeping up to date with HIV is essential because guidance, treatments, and prevention strategies continue to evolve. Updated testing recommendations and changing patterns of transmission mean that best practice today may look different from even a few years ago. Staying current helps ensure early diagnosis, effective treatment, reduced transmission and the best possible outcomes for patients. For professionals, it also supports safe, evidence‑based care and helps combat stigma by promoting an accurate and modern understanding of the condition.

 

HIOWH Sexual Health and HIV Service

As the HIV service for Hampshire and the Isle of Wight, we aim to support professionals in staying informed and confident in their practice. We do this by regularly sharing up‑to‑date information and resources on our website, and by offering training sessions and webinars tailored to emerging trends and evolving guidance. Our goal is to ensure that all professionals across the region have access to the knowledge and support they need to deliver high‑quality, inclusive, and up‑to‑date HIV care. Our events and webinars can be found at Webinars :: Hampshire and Isle of Wight Healthcare Sexual Health

 

Terrence Higgins Trust

THT provide a variety of training offers both online and at their centres to support professionals in developing skills and knowledge. Their training offers can be found at: Training | Terrence Higgins Trust

 

E-LFH

Access to e learning can be accessed at https://www.e-lfh.org.uk/programmes/sexual-health-and-hiv/  The e-Learning for Healthcare Sexual Health and HIV programme provides a comprehensive set of online modules that cover a wide range of topics related to HIV including HIV testing, management and prevention, along with dedicated sessions about HIV Pre‑Exposure Prophylaxis (PrEP). In addition they have a specific module on HIV Stigma in Healthcare which can be accessed at: Tackling HIV Stigma and Discrimination - elearning for healthcare

 

Events

Events play a crucial role in raising awareness and providing education by creating focused moments that encourage people to engage with important health messages. National HIV Testing Week is a strong example of this and is an annual campaign led by HIV Prevention England that takes place each February aiming to promote regular HIV testing. Information on their campaign can be found at National HIV Testing Week – HIV Prevention England

 

Webinars 

 

HIV and STIs: A Sexual Health Perspective for Inclusive and Effective Practice – April 20^th 2026, 11am. (LINK TO FOLLOW)

This training webinar provides professionals and volunteers with an up‑to‑date, accessible overview of HIV and sexually transmitted infections. It focuses on improving confidence, reducing stigma, and strengthening inclusive sexual‑health conversations. Participants gain practical knowledge to support individuals and communities affected by or at risk of HIV and STIs, alongside clear guidance on prevention, testing, and treatment.

Learning Outcomes

By the end of the webinar, participants will be able to:

Enhance their knowledge of HIV and STIs, including transmission, prevention, testing, and treatment.

Build confidence in having open, non‑judgmental sexual‑health conversations using effective communication techniques.

Increase awareness of current prevention strategies such as PrEP, PEP, condoms, vaccinations, and regular testing.

Recognise and challenge stigma, understanding its impact on testing, disclosure, and health outcomes, and apply inclusive, person‑centred approaches.

Support access to services through accurate signposting and awareness of sexual‑health pathways.

 

HIPS Training videos – Coming Soon

Case studies – Coming Soon

 

Challenging myths and misconceptions:

Common myths about HIV include misconceptions about transmission, treatment, and the demographics affected, which can perpetuate stigma and misinformation.

Myth 1: HIV is Spread Through Casual Contact

Fact: HIV is not transmitted through casual contact such as hugging, kissing, or sharing utensils. The virus is primarily spread through specific bodily fluids, including blood, semen, vaginal fluids, and breast milk from an infected person.

Myth 2: Only Certain Groups are Affected by HIV

Fact: HIV can affect anyone, regardless of sexual orientation, age, or lifestyle. While certain populations may have higher rates of infection, anyone can contract HIV through unprotected sexual intercourse, sharing needles, or from mother to child during childbirth or breastfeeding.

Myth 3: You Can Tell if Someone is HIV-Positive by Looking at Them

Fact: Many people living with HIV may not show symptoms for years. The only way to know if someone is HIV-positive is through testing.

Myth 4: HIV is a Death Sentence

Fact: With advancements in medical treatment, particularly antiretroviral therapy (ART), individuals with HIV can lead healthy and fulfilling lives. While there is no cure, effective treatment allows people to manage the virus and reduce their viral load to undetectable levels, meaning they cannot transmit the virus to others.

Myth 5: Mosquitoes Can Transmit HIV

Fact: HIV is not transmitted by mosquitoes or other insects. The virus does not survive long enough in an insect's body to be transmitted through bites.

Myth 6: Oral Sex is Safe from HIV Transmission

Fact: While the risk of HIV transmission through oral sex is lower compared to anal or vaginal sex, it is not zero. Factors such as the presence of cuts or sores can increase the risk.

Understanding and debunking these myths is crucial for reducing stigma and promoting a more informed perspective on HIV. Education and awareness can help foster empathy and support for those living with HIV, ultimately contributing to public health efforts to combat the epidemic.

Events & training 

The following resources bring together a growing range of educational tools to support GPs in building confidence and expertise around HIV prevention, testing, and patient communication. A selection of key resources is available now, including links to national initiatives such as National HIV Testing Week, the HIV Confident programme, and high‑quality e‑learning from partners including e‑Learning for Healthcare and the Terrence Higgins Trust.

Additional content—such as live and on‑demand webinars, HIPS training videos, case studies, and resources to help challenge myths and misconceptions—is currently in development and will be added soon. As this section evolves, it will offer a comprehensive hub of training opportunities and practical learning to help embed best practice across primary care. More resources will be launched shortly—please check back for updates.

 

National HIV Testing Week – HIV Prevention England

HIV Confident | Building a world that welcomes and respects

Sexual Health and HIV - elearning for healthcare

Tackling HIV Stigma and Discrimination - elearning for healthcare

Training | Terrence Higgins Trust

Why Stigma Matters 

• Stigma is a social process involving prejudice, stereotyping, and discrimination against people living with HIV (PLWH). It manifests as:
  • Enacted stigma: discrimination and unfair treatment.
  • Anticipated stigma: fear of future discrimination.
  • Internalised stigma: self-blame and shame.
• Impact on health:
  • Stigma delays HIV testing, reduces treatment adherence, and worsens mental health. It is a major barrier to prevention and care.
• Where stigma occurs:
  • Healthcare settings: Negative attitudes or lack of knowledge among staff.
  • Media and public discourse: Misrepresentation fuels fear.
  • Structural level: Laws, policies, and organisational practices.
  • Self-stigma: Internalised shame among PLWH.

 

• What works to reduce stigma.
   
  • Evidence-based interventions include:
    • Use accurate, positive messaging about HIV and treatment.
    • Promote “Undetectable = Untransmittable (U=U)” to reduce fear.
  • Involving People Living with HIV
    • Peer-led education and storytelling humanise HIV.
    • Representation in campaigns builds trust.
  • Discussing Stigma Directly
    • Address myths and misconceptions openly.
    • Include stigma reduction in HIV education.
  • Organisational Change
    • Train healthcare staff on HIV facts and stigma awareness.
    • Create welcoming environments for HIV testing and care.
  • Addressing Self-Stigma
    • Provide mental health support and peer networks.
    • Encourage disclosure in safe spaces.

This section provides GPs with an emerging set of resources designed to deepen understanding of HIV‑related stigma and support stigma‑free, inclusive care. A selection of materials is available now, including evidence‑based guidance on why stigma matters, how it affects health outcomes, and practical tools such as the Inclusive Language Toolkit and Person‑First Language resources.

Links to national guidance on reducing stigma in healthcare settings are also included. Further content—such as expanded information on effective stigma‑reduction interventions, guidance on creating supportive care environments, and practical examples involving people with lived experience is currently in development and will be added soon. As this section grows, it will offer GPs clear, actionable approaches to challenge myths, improve communication, and help ensure every patient feels respected, safe, and supported. More resources will be published shortly as this section continues to evolve.

​​​​Tackling-HIV-Stigma-What-works.pdf

  Ensuring quality health care by reducing HIV-related stigma and discrimination-

• Inclusive language toolkit
  • Person First Language (PFL) People First Charter - HIV Language, Person First Language
• Creating supportive care environments

 

Behavioural science offers valuable insights into how people make decisions about their health, providing an important foundation for improving support for individuals living with HIV. By understanding the psychological, social and environmental factors that influence behaviours such as medication adherence, clinic attendance and risk reduction, healthcare teams can design more effective, person centred interventions. These insights help identify barriers, reinforce motivations and shape supportive environments that empower patients to engage confidently with their treatment and overall wellbeing.

Building on these behavioural science insights, the COM B framework provides a practical way to understand the specific factors influencing health behaviours among people living with HIV. COM B proposes that behaviour is driven by three essential components: Capability, Opportunity and Motivation. By examining whether individuals have the necessary knowledge and skills (Capability), supportive social and physical environments (Opportunity), and the desire or confidence to act (Motivation), healthcare teams can more precisely identify what enables or hinders treatment engagement. This structured approach helps clinicians tailor interventions—such as adjusting information, strengthening support systems or enhancing motivational strategies—to better meet patients’ needs and promote sustained positive health behaviours. The link to further information can be found here: Further COM-B information | NHS England | Workforce, training and education

 

Health Education England has introduced the Behaviour Change Development Framework and Toolkit to equip both individuals and workforce leads with the skills to assess and strengthen behaviour change capabilities. Designed to support workforce development, the toolkit offers a range of resources—including assessment tools, e learning modules, videos and practical learning activities—to help users review and enhance their behaviour change skills. The link to the Framework and Toolkit can be found here: 

Behaviour Change | NHS England | Workforce, training and education

 

HIV peer support is about one person living with HIV listening and supporting another.  We can provide patients with Peer Support if they are accessing their HIV care from our service. For complex peer support we also have a complex peer supporter from Thames Valley Peer Support available.  Peer support can be provided over the phone or in person.

Patients can self-refer for Peer Support via email address: hiowh.hivpeersupport@nhs.net or by phoning:

North (Aldershot, Basingstoke and Eastleigh) – 02381 031207

Portsmouth and IOW – 02381 031209

Southampton – 02381 031208

Listed below you will find direct links to local and national peer support services, including TVPS, Terrence Higgins Trust (with dedicated Hampshire resources), My Community platforms, and Positively UK’s peer‑led support and advocacy services. These organisations play a vital role in reducing isolation, improving wellbeing, and empowering individuals through lived‑experience‑based guidance. Additional content and local partner information will continue to be added as the section develops, ensuring GPs can easily signpost patients to high‑quality, accessible support networks across the region.

• Partner organisations (Hampshire, IOW, Portsmouth, Southampton)
• HIV Peer Supporters
  • TVPS
• THT Homepage | Terrence Higgins Trust
  • Terrence Higgins Trust Hampshire | Facebook
  • My Community
     
• Peer Support | Positively UK - HIV Peer-Support, Advocacy and Information

 

This Policy & Guidance section brings together key national and local frameworks that support evidence‑based HIV prevention, testing, and care within primary care. It includes direct links to essential policy documents such as the Towards Zero: HIV Action Plan for England (2022–2025), alongside authoritative clinical guidance from BHIVA, BASHH, and NICE on HIV testing, diagnosis, and care pathways.

Resources tailored for primary care—such as HIV Prevention England guidance and NICE quality standards for areas with high or extremely high HIV prevalence—are also available to help GPs align practice with current expectations and best practice recommendations. Additional local policy content, currently under review, will be added as the section develops. Once published, this area will serve as a comprehensive reference hub to support consistent, informed decision‑making across general practice.

 

• National and local HIV prevention policies - Coming Soon  
  • Towards Zero: the HIV Action Plan for England - 2022 to 2025 - GOV.UK
  • BHIVA – BHIVA is the leading UK association representing professionals in HIV care
  • Guidelines | BASHH
  • HIV infection and AIDS | Health topics A to Z | CKS | NICE
  • Overview | HIV testing: increasing uptake among people who may have undiagnosed HIV | Guidance | NICE
  • GPs and primary care professionals – HIV Prevention England
  • Quality statement 2: General practice in areas of high and extremely high HIV prevalence | HIV testing: encouraging uptake | Quality standards | NICE
     

• Key contacts

https://www.letstalkaboutit.nhs.uk/download_file/view/db658eba-1029-42d5-af38-58c9a6f53f8b/457/333

• Feedback form – Coming Soon