What are the current guidelines for HIV screening in high-risk populations in primary care?

In primary care settings, HIV testing should be offered and recommended to everyone who has not previously been diagnosed with HIV and who presents with symptoms that may indicate HIV or is part of the differential diagnosis, such as infectious mononucleosis-like syndrome ¹.

HIV testing should also be offered to individuals known to be from a country or group with a high rate of HIV infection, men who have sex with men who have not had testing in the previous year, trans women who have sex with men and have not been tested in the previous year, individuals reporting sexual contact with someone from a high prevalence country, those engaging in high-risk sexual practices such as chemsex, individuals diagnosed with or requesting testing for sexually transmitted infections, those with a history of injecting drug use, and sexual partners of known HIV-positive individuals or those at high risk ¹.

In areas of high and extremely high prevalence, HIV testing should be routinely offered on registration with the practice, during blood tests for other reasons, and opportunistically at each consultation based on clinical judgment ¹.

Repeat testing is recommended for high-risk groups, such as men who have sex with men and individuals with high-risk sexual behaviors, at least annually, or more frequently if at high risk, with reminders via call-recall methods ¹.