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Pharmacists highlight concerns over law change governing HIV home-testing kits

The law is being changed on 6 April 2014 to allow the sale of regulated HIV home-testing kits in Britain as part of the Government’s drive to encourage more at-risk groups to be screened for the virus.

Although the move is significant, its impact will not be felt until at least the end of the year when the first UK-licensed kits are expected to become available.

Community pharmacists with an interest in HIV screening are concerned about the effect offering home-testing kits will have on the profession and said it is imperative that a proper care pathway is in place for those people who have a positive result.

Jignesh Patel, from Plaistow, Essex, was involved in piloting an opportunistic HIV screening programme run by community pharmacists. Of the 800 patients screened during the pilot, eight were found to be HIV positive, he said.

He told PJ Online: “There was a whole pathway in place — it wasn’t just a pharmacy-based screening programme. There was counselling and referral and follow-up.”

He said the potential impact of the law change on community pharmacy could be “huge”, especially if genitourinary medicine clinics are not geared up to cope with the extra demand.

He said: “There will need to be a proper referral pathway in place because the issue is going to be where will these people, who have a positive test result at home, go?

“Also, HIV screening isn’t like screening for high blood pressure or diabetes where there isn’t a stigma; people tend to be fairly secretive about it.” 

In Holston, Hackney, community pharmacist Raj Radia has just been commissioned by his local borough council to provide an opportunistic HIV screening programme for at-risk groups. He will refer people who test positive to their GP, he said.

Mr Radia is concerned about workload implications when home-testing kits become available because people will seek advice from their community pharmacist when they are unable to arrange an appointment with their GP.

“We are accessible health professionals and GPs have become so inaccessible with their appointments system,” he said. 

Under the current HIV Testing Kits and Services Regulations 1992, companies are unable to sell self-testing kits in the UK because the test result has to be given by a health professional.

Private HIV screening is available in the UK and some online pharmacies as well as the sexual health charity the Terrence Higgins Trust offer a service, which can cost up to £40 a test. Under these schemes patients test themselves at home but return the sample for analysis before being given the result.

Unregulated self-testing kits can be bought in the UK over the internet but their quality is not guaranteed.  

The change in the Regulations was welcomed by the Royal Pharmaceutical Society. Heather Leake-Date, consultant pharmacist at Brighton and Sussex University Hospitals NHS Trust and an honorary senior lecturer at the University of Brighton, is working with the RPS to provide HIV training material for community pharmacists following the change in the Regulations.

She said: “People will be able to buy these kits from a community pharmacist so it’s important that they have the information they need to signpost people to their local sexual health clinic for an appointment, which is usually within 48-hours if not sooner.”

She said making home-testing kits — which will be regulated by the Medicines and Healthcare products Regulatory Agency — available in the UK would address the problem of unregulated kits being available and bought online. 

She said: “That is one of the reasons for a change in the law because people are accessing home-testing kits on the internet which have not been through the UK regulatory system.”    

 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11136902

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