To think consent is required to do a HIV or hepatitis blood test??

[Onionbhajisandwich]

Hi all,

Please tell me if I’m wrong here but do the NHS require consent to test for HIV or Hepatitis?? I would have thought they did.

I attended A and E last month (sent by my GP) as I had suspected pneumonia. I received a text today stating this:

“You recently attended the Emergency Department. We are part of an NHS programme testing for HIV, Hepatitis B and C but your test wasn't processed due to technical issues. Please attend one of the walk-in blood test centres, Mon - Fri 8am- 4.30pm. We requested the repeat test electronically, so please give your NHS number on arrival. We will only contact you if the test is positive and you need care”

I’m a bit surprised that they can screen you without consent - as far as I knew the blood tests that they did we for infection markers and a full blood count, along with one that checks for clotting.

I won’t be attending to get the tests done as it’s within work time but aibu to think this isn’t ok??

That's an interesting point. Our blood results are uploaded onto their maternity app. Plus we have the ethos of women centred care and working in partnership with the women so we are meant to have informed med consent, it's a standard

If I'm taking pet bloods, I'll say we are looking at liver function, kidney function, full blood count and coagulation. If I'm doing a torch screen I say we are looking for infection markers including toxoplasmosis, parvovirus, rubella etc. Most people are happy with that but if someone wishes to have more detail then that's for them. I've personally never known anyone to want a full breakdown into every result. Yes in a very busy dept it's hard to find the time but that's the patients right.

When they say “I’m just going to take some blood,” and you roll up your fsleeve and allow them to insert the needle, you have given consent for them to test for whatever it is they’re testing for. Including routine screenings for conditions such as HepB and HIV.

Of course you can ask what they’re testing for and they will tell you. Equally if you have a routine blood test booked the elements they’re testing will appear on the blood form.

But to suggest that you need to give consent for each individual element being tested for just isn’t feasible. By all means if you object to being tested for HIV or hepatitis’ B you can easily object at the time by asking “are you testing for HIV?” But a full blood count is massive. And there are multiple elements which are sub counts etc.

When I have blood tests they test so many things I would be there all day if I individually consented to each one of them. When I went for my transplant assessment they took ten bottles 😱. They actually do send the blood results to me as part of the letter they send to my GP, and most of it to me is like another language, except the NT pro BNP level which is my little obsession as it gives an insight into how bad my heart failure level is.

”infection markers” covers any infectious disease. HIV and Hepatitis are infectious diseases.

I was in hospital six months ago and they were forever taking blood. I’m sure if I’d of asked they’d of given a detailed run down but really I felt awful so someone saying I’m just going to draw some blood for testing was sufficient. I think they do lots of tests as every time it was 4 or 5 tubes with different coloured lids.

I was tested for HIV as a teenager at A&E with a scalded hand. It was part of a regional pilot.

I explained I would prefer they didn't as I was a virgin who had never taken drugs or used dirty needles, and my parents (due to strict religious beliefs) had been each others only sexual partners so no chance my mother passed HIV on at birth, so it was a complete waste of NHS time and resources. They went ahead anyway and staff member was quite rude to me about "judging lifestyles" and I also had to have a telephone appointment to discuss my (negative) result which appeared to have a 20 minute script that was another waste of NHS time and resources.

I went through it all recently again at A&E with heart issues and wasn't given the option of opting out. They'd already taken the blood and filled out the paperwork. I did say this time, "I think it's a waste of time as I know I don't have HIV, so if there's any chance it's going to delay me in A&E and waste resources, please could we not?" The sexual health HCA then paid me a call, to explain "it's not a moral or value judgement of your lifestyle, it's just a scheme that's being run at the moment..." and I got a long "education" on HIV, the scheme, why it was important, what would happen in the event of a positive result and to cut a long story short was manipulated into giving my consent after my bloods had already been sent to the lab. And probably manipulated into not complaining too.

And the same patronising HCA called me back for another long spiel with the (negative) results, how to keep safe in future etc.

I just had no option but to keep nodding and listening...I was more worried about the heart condition at the end of the day and just wanted to be appropriately cared for.

ETA...I was especially annoyed because the HCA was a general A&E HCA who'd taken on an additional sexual health/HIV screening role and I couldn't believe the waste of resources when there were very sick elderly people in the corridor next to me who were getting next to no attention or care, being left in their own waste, covered in vomit. It was heartbreaking. The NHS really gets it wrong sometimes.

That is appaling and worthy of a complaint to the local trust. I think many of us are a bit too compliant with what information the government holds on us. Look at the ridiculous ideas & suggestions during covid which included a requirement to hold a vaccination card to enter public spaces.

But if you have been pregnant in the last 20 years or attended a sexual health clinic you will have had an HIV test. So many, many people will have.

I think you are quite judgy. There are people with HIV that were also virgins, non drug users and had nice parents.
how horrible that you still talk like that.

It’s done as routine in my A&E. I don’t really understand the objection to it, tbh

HIV infections in heterosexual relationships are on the rise

https://www.gov.uk/government/news/rise-in-hiv-diagnoses-steepest-among-heterosexual-men-and-women

You are being tested because it is clinically indicated. Some places operate an opt out system because otherwise patients would refuse the test because of past stigma. The earlier patients are diagnosed the better the prognosis.

You can live a long and fulfilled life with HIV with the advances in modern medicine. Dr Pembleton wrote in the spectator a few years ago that he'd rather have HIV than diabetes.

HIV testing should be done much more routinely than it currently is. Shouldn’t be any different to having any other blood test. Finding out you have it and starting treatment is always going to be better than not knowing, whilst it quietly destroys your immune system.

It's not judgy.

It's just facts.

I couldn't have got through sex.

Needle use.

My mother being pregnant with me.

Or any other way that HIV is transmitted. So how could I have got it? It was a waste of time and resources for the NHS.

Which could have been better spent on my friend Ant who has been living with HIV for the past 20 years and watched his lovely partner die of it in the early 90s.

Wow!!

I’m shocked by this. YANBU OP- consent should be a requirement.

I spent several years working for a pilot rapid test scheme in a developing country, I couldn't begin to tell you the number of positive tests I have conducted on people who couldn't possibly have contracted HIV. Routine testing is designed to catch the people who don't think they have it, because anyone can get it, and people lie. You're taking it personally because of stigma.

Im having routine bloods done every 5 mins atm (in a black hole between trusts which dont communicate or share results so everything has to be redone).

The results always show HIV, Hep status. I swear a few others as well! But app is frozen so cant see.

I always assumed it was more about the healthcare workers. They have a right to know if you have HIV or Hep surely as these are infectious blood diseases and they are working with your blood?

When I did my hiv module at uni in around 2012 at uni we were told the prevalance in heterosexuals now actually exceeds homosexuals.

The life expectancy for hiv is higher than that of dm

Absolutely nothing to do with that in the slightest. We are taught to assume everyone has bbv as so many are undiagnosed. There's actually some evidence are more likely to have issues in known BBV as some change their behavior eg wear 2 pairs of gloves - which reduces your dexterity and means your more likely to needle stick yourself than if you just did your normal practice

The transmission rates are tiny anyway I've managed to get blood in my eye with hep b/c/hiv in it and didn't catch any

You must be abit older than me so at least in your 50's ? Your attitude is out of date and misplaced please educate yourself, it hasn't been the '90s for at least 25 years now.

Jesus! That would have freaked me out.

You do a good job as healthcare. Thank you 😊

I really can't see the problem with this.

I wouldn't mind at the A and E as I'm already there but I wouldn't be traipsing to the clinic because their test didn't work as it is about 5 miles away.

I'm in my 30s.

So your friend is much older than you ? No British born 30 year old should have lost a partner to AIDS, effective anti-retroviral treatment has been available on the NHS since the mid 90s.

To be honest I am shocked that some one so young would have your attitiudes. Did you not grow up in the UK ?

It's nothing to do with stigma.

It's to do with personally not wanting to waste the time of the NHS when I know I don't have HIV (I don't. As numerous tests have shown). It's important to me because I am the only person in my family who doesn't work for the NHS and I know the hell they go through due to underfunding and pointless box ticking exercises. I get that it's not pointless for everyone and is important and has it's place. But there should be an option for individuals to make an educated choice for themeselves to opt out that is respected by staff.

I'm British Asian from a Muslim family.

My friend was a teenager when he met his late partner, who was over 20 years older than him. He's in his 50s now. I shouldn't have to justify myself, or any of my friends. I'm not a bigot. I've faced a lot of it though. I don't consider myself better than anyone because I had a strict background. It's just life.

You keep picking on me because I am from a different background to you so just to make it clear I won't be responding to you any further. No need to waste your energy anymore. We aren't going to get anywhere.