Not enough women being checked for HIV ‘despite them making up substantial new diagnoses’

‘In sexual health clinics, women are least likely to be offered a HIV test. Especially women from ethnic minority backgrounds. Some providers think it is not what the woman is coming to see them for,’ says expert

A person with HIV who gets a late diagnosis has an eight times greater risk of death in comparison to those who are diagnosed at an earlier date (AFP/Getty Images)

Healthcare providers are not checking enough women for HIV, despite them making up substantial amounts of new diagnoses, leading charities warned.

Experts note the amount of gay and bisexual men being diagnosed with HIV has dropped during recent years but the figures have remained far steadier for women.

While women constituted 28 per cent of new HIV diagnoses in 2019, some 29 per cent of all people who have been diagnosed with HIV in the UK are women.

Chamut Kifetew, of Terrence Higgins Trust, the UK's leading HIV and sexual health charity, said women are often overlooked by healthcare professionals.

Speaking to The Independent on World Aids Day, Ms Kifetew said: “In sexual health clinics, women are least likely to be offered a HIV test. Especially women from ethnic minority backgrounds. Some providers think it is not what the woman is coming to see them for. They think the woman should be the one to ask.

“While the woman might think if their doctor or healthcare professional wanted them to do a test, they would ask them to. It is important we rethink this and bring women to the forefront in healthcare professionals’ minds.

“Women themselves may also not see that they are at risk of HIV. But women can get it and do get it. They are often diagnosed later when the virus has already affected the body which puts them at risk of dying sooner. Women often don’t feel comfortable asking for a HIV test in relationships. All it takes is having unprotected sex once to get HIV. You cannot tell whether someone has HIV from looking at them. Someone can be a man, woman, old or young and have HIV.”

Ms Kifetew, who oversees England’s national HIV prevention programme, warned there is a postcode lottery among services that provide testing.

She said healthcare services are aware what they should be doing but this needs to be “enforced” — adding that sexual health clinics often assume women are there to access contraception or a chlamydia test rather than be screened for HIV.

A person with HIV who gets a late diagnosis has an eight times greater risk of death in comparison to those who are diagnosed at an earlier date. Around 5,900 people are living with undiagnosed HIV in England at the moment — meaning they may be unknowingly passing the virus onto others.

Ms Kifetew’s comments come as the HIV Commission releases a new report demanding HIV testing to be standard whenever blood is drawn in a healthcare setting — irrespective of the individual’s gender, sexuality or ethnicity.

The HIV Commission, set up by leading HIV charities such as Terrence Higgins Trust, National AIDS Trust and Elton John AIDS Foundation, said the expansion of testing is a key way to meet the government’s promise to wave goodbye to new HIV cases by 2030.

Mercy Shibemba, HIV Commissioner and campaigner, said: “As someone living with HIV, I can say with confidence that it’s one of the most highly stigmatised health conditions there is. Our HIV Commission process found that those three letters — HIV — still strike fear in people’s hearts and make them too scared to come forward to test.

“If we’re to reach our 2030 goal of ending HIV cases, we also need to take the urgent and drastic action to address the stigma and discrimination still surrounding HIV outlined in our report. That includes addressing significant health inequalities to ensure no community is left behind."

The proportion of women who are diagnosed with HIV each year has remained roughly the same in the last decade, with the number dropping only four per cent since 2010. Whereas, the number of new diagnoses has fallen by 18 per cent among gay and bisexual men.

Public Health England estimates there were just over half a million missed opportunities to test eligible people in specialist sexual health clinics last year — while half of those were not offered a test, the other half refused to have one.

There is a massive disparity in the different demographics who refuse a test — while only four per cent of gay and bisexual men decline a test, 20 per cent of Black African heterosexual women and nine per cent of Black African heterosexual men refuse a test, in spite of them being the two groups most affected by HIV in England.

Dame Inga Beale, the HIV Commission’s chair, said: “Zero new HIV cases in England by 2030 isn’t a pipedream or social media-friendly date plucked from the air — it’s 100 per cent achievable.”

Campaigners said maternity services are a shining example when it comes to routine HIV testing — noting there is now a 99 per cent testing coverage meaning there are virtually no babies being born with HIV in England.

HIV testing should be standard practice when registering for a GP, attending a smear test, as well as in pharmacies and in A&E, campaigners said.

Sir Elton John, a leading HIV campaigner, said: “One thing we’ve learned this year is the importance of testing and testing for HIV is at the core of ending new cases of HIV in England.

“It’s so important for everyone to know their HIV status to protect themselves and others. Making HIV testing available and normalised throughout the health service not only means people can be treated but by testing becoming routine, this removes some of the stigma that’s holding us back.”