eC

EUROPEANCENTREFORDISEASEPREVENTION

ANDCONTROL

EuropeanstandardsofHIV

preventionandcare:

ModuleonHIVtesting

i

ECDCOPERATIONALSUPPORT

EuropeanstandardsofHIVpreventionandcare:ModuleonHIVtesting

EuropeanstandardsofHIVpreventionandcare:ModuleonHIVtestingOPERATIONALSUPPORT

ii

ThisreportbytheEuropeanCentreforDiseasePreventionandControl(ECDC)wasledbyTeymurNoori.ThedraftversionwasproducedunderaspecificcontractwiththeEuropeanCentreforDiseasePreventionandControl

(ECDC).TheEuropeanAIDSClinicalSociety(EACS)wasawardedthisspecificcontractunder‘EuropeanstandardsofHIVcare’(Frameworkcontractnumber:ECDC/2022/0210)

ThisreportonstandardsofcareforHIVTestingisoneinaseriesofstandardsforHIVcare.Otherreportsinthe

seriescanbefoundonECDC’swebsiteat:

https://www.ecdc.europa.eu/en/infectious-disease-topics/hiv-infection-

and-aids/ecdceacs-standards-hiv-care

ECDCwouldliketoacknowledgethesupport,guidance,andqualityassurancethroughoutthedurationofthe

projectprovidedbymembersoftheStandardsofCareAdvisorygroup:AlmaCicic(Montenegro),CarolineHurley(Ireland),CianánRussell(Europe),CristinaMussini(Italy),CristianaOprea(Romania),DenizG?kengin(Türkiye),DominiqueVanBeckhoven(Belgium),FerencBagyinszky(Germany),GeorgBehrens(Germany),JoseBernardino(Spain),OmarSyarif(Global).

ECDCwouldalsoliketothankthewritinggroupfortheirtime,energy,andtechnicalexpertiseinthedraftingoftheStandardsofCare:AnnSullivan(UK,writinggrouplead),CarolineHurley(Ireland),CristinaMussini(Italy),

CristianaOprea(Romania),DenizG?kengin(Türkiye),DortheRaben(Denmark),EstebanMartinez(Spain),FerencBagyinszky,(Germany),JoseBernardino(Spain),JürgenRockstroh(Germany),OmarSyarif(Global),Sanjay

Bhagani(UK),TeymurNoori,(ECDC).

ECDCwouldalsoliketothanktheSoCprojectcoregroupmembersfortheirdedicatedsupportinpreparingtheapplicationforthisprojectandforprovidingday-to-daysupporttotheworkingprocess;AnnSullivan(Expert

EACS),DanielSim?es(ExpertCommunity),DortheRaben(CHIP),EstebanMartinez(ExpertEACS),FionaBurns

(ExpertEACS),JoelleVerluyten(EACS),JürgenRockstroh(ExpertEACS),MiloszParczewski(ExpertEACS),SanjayBhagani(ExpertEACS),TeymurNoori,(ECDC).

ECDCwouldalsoliketothanktheEuropeanStandardofCareCoordinationteamfromEACSandCHIPforjointly

coordinatingtheworkandensuringsupporttoallphasesoftheproject.TheprojectteamconsistsofDortheRaben(CHIP)andJoelleVerluyten(EACS),includingprojectcoordinatorsAnneRaahaugeandSusanneOlejas(CHIP)andOlgaFursa.

Suggestedcitation:EuropeanCentreforDiseasePreventionandControl.EuropeanStandardsofHIVprevention

andcare:ModuleonHIVtesting.Stockholm:ECDC;2025.

Stockholm,June2025

ISBN978-92-9498-807-2

doi:10.2900/2286502

CataloguenumberTQ-01-25-037-EN-N

?EuropeanCentreforDiseasePreventionandControl,2025

Reproductionisauthorised,providedthesourceisacknowledged

OPERATIONALSUPPORTEuropeanstandardsofHIVpreventionandcare:ModuleonHIVtesting

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Contents

Abbreviations iv

Backgroundandintroduction 5

Methodology 6

1.General 7

2.Testingpolicies 8

3.Testing 9

strategies

4.Consent 11

5.Diagnosisandtransfertocare 12

6 14

Stafftraining

7.Monitoringandevaluation 15

Applyingthestandards 15

References 17

Annex1.Contributorstotheofthestandards 18

development

Annex2.Overviewofqualitystatementsandindicators 19

Tables

Table1.Qualitystatements,andtargetsfor1‘General 7

indicators,topic(overallqualitystatement)’

Table2.Qualitystatements,andtargetsfor2‘Testing8

indicators,topicpolicies’

Table3.Qualitystatements,andtargetsfor3‘Testing9

indicators,topicstrategies’

Table4.Qualitystatements,andtargetsfor4‘Consent’..............................................................................11

indicators,topic

Table5.Qualitystatements,andtargetsfor5‘Diagnosisandtransfertocare’..............................................12

indicators,topic

Table6.Qualitystatements,andtargetsfor6‘Staff.......................................................................14

indicators,topictraining’

Table7.Qualitystatements,andtargetsfor7‘Monitoringandevaluation’....................................................15

indicators,topic

EuropeanstandardsofHIVpreventionandcare:ModuleonHIVtestingOPERATIONALSUPPORT

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Abbreviations

ARTAntiretroviraltherapy

CHIPCentreofExcellenceforHealth,Immunity,andInfections

EACSEuropeanAIDSClinicalSociety

ECDCEuropeanCentreforDiseasePreventionandControl

EU/EEAEuropeanUnion/EuropeanEconomicArea

FWCFrameworkcontract

GAMGlobalAIDSMonitoringFramework(UNAIDS)

GCPGoodclinicalpractice

GDPRGeneralDataProtectionRegulation

HBVHepatitisBvirus

HIVHumanimmunodeficiencyvirus

ICIndicatorCondition

MSMMenwhohavesexwithmen

PLHIVPeoplelivingwithHIV

PNPartnerNotification

PWIDPeoplewhoinjectdrugs

QSQualitystatements

SDGSustainableDevelopmentGoals

SoCStandardsofCare

STISexuallytransmittedinfections

WHOWorldHealthOrganization

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Backgroundandintroduction

Anestimated2334662peoplearelivingwithHIVinEuropeandCentralAsia,1944695ofwhom(83%;range65–100%)havebeendiagnosed[1].Thisisapproximatelyoneinsix(17%)peoplelivingwithHIVinEuropeandCentralAsiabeingunawareoftheirstatus.Inthe26EU/EEAcountrieswithreporteddata,91%(706541;range77?98%)oftheestimated778237peoplelivingwithHIVhadbeendiagnosed.Thisisequivalenttonearlyonein10peoplelivingwithHIV(9%)intheEU/EEAhavinganundiagnosedHIVinfection.

In2023,therewere110486peoplenewlydiagnosedwithHIVacrossEuropeandCentralAsia[2].Ofthesenewdiagnoses,54%weremadeatalatestageofinfection(CD4cellcount<350cells/mm3atthetimeofdiagnosis),including34%withadvancedHIVinfection(CD4cellcount<200cells/mm3)[2].LateHIVdiagnosisremainsa

challengeinallcountriesintheregion.ThepercentageofpeoplenewlydiagnosedwhowerediagnosedlatevariedacrosstransmissioncategoriesandagegroupsbutwashighestforpeoplewhoacquiredHIVthroughheterosexualsex(55.0%all;60.9%formenand53.9%forwomen)andpeoplewhoinjectdrugs(47.0%),andlowestformenwhohavesexwithmen(41.0%).Latediagnosisincreasedwithage,rangingfrom35.8%amongpeopleaged20–24yearsatdiagnosis,to66.5%amongthoseaged50yearsorabove[2].

WhatarestandardsofcareforHIV?

Thestandardsofcare(SoC)forHIVdefinetheexpected,ordesired,qualityofprevention,treatment,andcareforpeopleatriskofHIVacquisitionorlivingwithHIV.

Thestandardsarebasedonascientificrationale,aswellastheresponsibilitiesofeachstakeholderandensurethatpeoplereceiveappropriate,high-qualitypreventionandcarethatalignswiththemostup-to-datemedicalknowledgeandethicalstandards.

TheEuropeanCentreforDiseasePreventionandControl(ECDC)inpartnershipwiththeEuropeanAIDSClinicalSociety(EACS)havedevelopedstandardsofcareintheareasofHIVtesting,pre-exposureprophylaxis(PrEP),antenatalscreening,commencementofART,andHIVandco-morbidities(addlinkstoSoCmodules).

Eachstandardisbasedonthefollowingstructure:

1.Briefdescriptionoftherationaleforthestandard.

2.Qualitystatementsdescribingbestpracticebasedoncurrentguidelines,evidence,andexpertopinion.

3.relatedmeasurableandauditableoutcomeindicatorsusedtoassessthequalityandeffectivenessoftheservices.

4.Numericvaluesfordefinedtargets.

Thestandardsareperson-centredintheirapproachwithaspecificfocusonbeingequitable,non-discriminatory,relevant,appropriate,andaccessibleforpeopleatriskoforlivingwithHIV.

Whoistheintendedaudienceofthestandardsofcare?

Thesestandardsofcarearedesignedforthreedistinctaudiences:

?peopleatriskofacquiringHIVorpeoplewhoarelivingwithHIV;

?peopleresponsiblefortheprovisionanddeliveryofHIV-relatedservices(serviceproviders);and

?peoplewhohaveresponsibilityforpolicy,guidancedevelopmentandcommissioningorfundingofHIVservices(Commissionersandpublichealthinstitutes).

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Methodology

HowwerethestandardsofHIVcaredeveloped?

Anadvisorygroupandtopic-specificwritinggroupsconsistingofrepresentativesfromclinicalcareproviders,publichealthpractitioners,communityorganisationsandpeoplelivingwithHIVfromacrossEuropewereestablished(seeannex1).Theadvisorygroupprovidedoverarchingadvicethroughoutthedurationoftheproject,supportedtheprioritisationofmoduleselection,prioritisationofqualitystatementsandindicatorsandreviewedtheSoCmodule.Thetopic-specificwritinggroupshavedevelopedthequalitystatements,indicators,andtargets(underthe

guidanceofanEACSexpertleadwriter)andalsoreviewedthefinalSoCtestingmodule.

Indevelopingthestandard,acombinationofconsensus-buildingtechniques,suchastheRAND/UCLA

AppropriatenessmethodandtheDelphimethod,wereused.TheRANDmethodisaformalconsensustechniquethatcombinesscientificevidencewithexpertopinionstocreateguidelines,recommendations,andquality

indicators,particularlyinhealthcaresettingsthismethodwasusedtoidentifytopicsfortheSoCsandfor

developingqualitystatementsandindicators.TheDelphimethodisastructuredcommunicationprocessthat

gathersexpertopinionsandfacilitatesconsensusthroughmultipleroundsofquestionsandfeedbackthismethodwasusedaspartofthewritinggroupmeetings.ThedraftingoftheHIVtestingstandardhasincludedareviewofexistingHIVepidemiologicaldataandevidence,andinternationalandnationalguidelines[4-8].

ThemethodologyhasbeendescribedinmoredetailinthemethodpaperonECDCswebsiteat:

https://www.ecdc.europa.eu/en/infectious-disease-topics/hiv-infection-and-aids/ecdceacs-standards-hiv-care

Qualitystatements,indicators,andtargets

TheSoCforHIVtestingisdividedintotopicsunderwhichqualitystatementsandindicatorshavebeendeveloped.ThetopicsarelistedbelowfollowedbythequalitystatementsdescribingbestpractisesandtheminimumserviceandcarethatapersonatriskoforlivingwithHIVshouldexpecttobeabletoaccessrelativetoHIVriskorstatusandacrossthelife-course.

Topics

1.General(overallqualitystatement)

2.Testingpolicies

3.Testingstrategies

4.Consent

5.Diagnosisandtransfertocare

6.Stafftraining

7.Monitoringandevaluation

Foreachofthequalitystatementslistedbelow,indicatorsandtargetshavebeendevelopedtosupportmonitoringofthevariousqualitystatements.

Adetailedoverviewofqualitystatements,indicators,numerator,denominator,targets,anddatasourcecanbefoundinAnnex2.

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1.General

Rationale

HIVtestingiskeytoachievingtheglobaltargetof95%ofPLHIVknowingtheirstatus.Furthermore,itisthe

essentialstepbywhichanindividualgainsaccesstotheremainderofthecarecontinuum,treatment,and

virologicalcontrolorthepreventionpathways,asappropriate.Whileprogresshasbeenmadeondiagnosing

PLHIV,HIVcasefindingremainschallengingacrosstheEuropeanregion,withfewcountrieshavingreachedthefirsttarget[1,2].

TestingcoverageremainslowinkeypopulationsinmanyEuropeancountrieswithlargevariationbetweensub-

regions,countries,andkeypopulationgroups[1,2].Furthermore,latediagnosiscontinuestojeopardisethehealthofPLHIVandisassociatedwithpoorerhealthoutcomes,increasedriskofHIVtransmissionandhigherhealthcarecosts[11].

Table1.Qualitystatements,indicators,andtargetsfortopic1‘General(overallqualitystatement)’

Qualitystatement

1EverybodylivingwithHIVshouldbeawareoftheirstatusinordertoaccesstimelytreatmentandcare.

Indicator

1.1PercentageofPLHIVwhoareawareoftheirstatus

Target

95%

1.2Percentageofpeoplediagnosedlate(CD4cellcount<350cells/uL)orverylate(CD4cellcount<200cells/uLorAIDSdiagnosis)

Target

Decreaseintotalnumberofpeoplediagnosedlateby

2%perannum

*Indicatorshighlightedinboldhavebeenselectedforprioritisationinordertomaximiseacceptabilityandfeasibilityofadoptionandreportingagainstthestandards.

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2.Testingpolicies

Rationale

Europeanguidelinesdescribewho,where,andwhentotestforHIV–withclearrecommendationsforpolicydevelopmentatnationallevelandimplementationinbothhealthcareandcommunitysettings[3-5],withmanyEuropeannationaltestingguidelinesfollowingtheseEuropeanrecommendations.However,effective

implementationoftheguidelinesappearstobemostlyinsufficientasdemonstratedbycountriesreportinglittlechangeintheleveloflatediagnosisovertime,withafewexceptions(UK,France)[6,7].

Table2.Qualitystatements,indicators,andtargetsfortopic2‘Testingpolicies’

Qualitystatement

2.1PolicymakersandlocalauthoritiesandothercommissionersofHIVtestingservicesshoulddesignHIVtestingprogrammesthatensureequitableaccesstoHIVtestingatalllevelsofhealthcareandtokeypopulationsinthecommunitybasedonlocalepidemiology.

Indicator

2.1PercentageofcountriesthatanalyseHIVprevalencedatabydemographicsandkeypopulations

Target

100%

Qualitystatement

2.2Community-basedtesting,includingcommunity-ledtesting,forkeypopulationsshouldbeanintegralpartofnational

testingprogrammesandshouldinvolvetheactiveparticipation(includingplanning,governanceanddeliverywithpeertestersandnavigators)oftherelevantcommunities.

Indicator

2.2PercentageofnationalHIVtestingstrategiesthatincludecommunity-basedtestingforatleastonekeypopulation

Target

100%

Qualitystatement

2.3HIVself-testingandself-samplingshouldbeofferedasanadditionalapproachtoHIVtestingservices.

Indicator

2.3Percentageofnationaltestingstrategiesthatincludeself-testingandself-sampling

Target

100%

Qualitystatement

2.4Universalopt-outtestingshouldbeimplementedinsettingswheretheaimisforallpeopleattendingtoacceptHIVtesting.

Indicator

2.4PercentageofhighHIVprevalencehealthcareservices*withanopt-outHIVtestingpolicy

Target

85%

*HealthcareservicescoveringapopulationwheretheHIVprevalenceishigh(e.g.>1%)and/orserviceswherethoseattendinghaveahighprevalencee.g.TBclinic).

Qualitystatement

2.5HIVtestingalgorithmsshouldachieveatleast99%positivepredictivevalueanduseacombinationoftestswith≥99%sensitivityand≥98%specificityandshouldfollowWHOrecommendations.

Indicator

2.5PercentageofnationaltestingstrategieswithHIVtestingalgorithmsthatfollowWHOrecommendations

Target

100%

*Indicatorshighlightedinboldhavebeenselectedforprioritisationinordertomaximiseacceptabilityandfeasibilityofadoptionandreportingagainstthestandards.

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3.Testingstrategies

Rationale

EffectiveHIVtestingstrategiesshouldbedevelopedaccordingtonationalepidemiologicaldataandtailoredtolocalpopulations,maximisingtheopportunityfortestinginbothclinicalandnon-clinicalsettings.Thisnecessitates

comprehensive,accuratedatabeingreportedbykeydemographicsandpopulationgroups[3].

TestingoutsideofhealthcareservicesisaparticularlyimportantapproachtoreachcertaingroupsathigherriskofHIVinfection,suchaspeoplewhoinjectdrugs(PWID),menwhohavesexwithmen(MSM),sexworkers(SWs)transgendermenandwomen,migrantsanddisplacedpersonsincludingincarceratedandhomelesspeople.

ExpandingHIVtestingoutsideofhealthcaresettingsimprovestestingcoverageandtheidentificationof

undiagnosedinfectioninpopulationsatriskofHIV.Inrecentyears,self-samplingandself-testinghaveemergedacrosstheEuropeanregionasbothacceptableandaconvenientmethodforaccessinganHIVtestandare

recommendedinEuropeanguidelines[3-5].

Engagingthecommunityinallstagesoftestingprogrammesfromdesigntodeliveryiskey.DeliveryofHIVtestingservicesbylayprovidersmayalsohelpclosethetestinggap,whileincreasinguptakeandacceptabilityofHIV

testingamongkeypopulationsandotherprioritygroupsandisrecommendedinEuropeanguidelines[3,5].

Table3.Qualitystatements,indicators,andtargetsfortopic3‘Testingstrategies’

Qualitystatement

3.1HIVtestingshouldbedeliveredinanenablingenvironmentthatremovesbarrierssuchasstigma,discrimination,andcriminalisation.

Indicator

3.1Noindicator

Target

--

Qualitystatement

3.2Allpeoplebelongingtokeypopulationgroups*shouldberoutinelyofferedandrecommendedHIVtesting;thoseatongoingriskshouldretestannually,ormorefrequentlydependingonrisk.

(*Keypopulations:MSM,transgendermenandwomen,PWID,migrantsanddisplacedpersons,sexworkers,incarceratedandhomelesspeople)

Indicator

3.2aPercentageofpeoplebelongingtoakeypopulationtestedforHIVatleastonceinthepast12months

Target

80%

Indicator

3.2bPercentageofpeoplebelongingtoakeypopulationtestedforHIVatleastonceinthepast12months,whoareattendingaspecifichealthcaresetting

Indicator

3.2cPercentageofpeoplefromkeypopulationswhoareawareoftheirHIVstatusinthepast12months(surveybased)

Qualitystatement

3.3HIVtestingshouldbeofferedtoallpeopleattendinghighHIVprevalence(>1%)healthcaresettings**.

(**HealthcareservicescoveringapopulationwheretheHIVprevalenceishigh(eg.>1%)and/orserviceswherethoseattendinghaveahighprevalenceeg.TBclinic).

Indicator

3.3PercentageofpeopleattendingahighHIVprevalencehealthcaresettingwhoaretestedforHIV

Target

85%orannual

performanceincreaseof5%from

baseline/previousyear

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Qualitystatement

3.4HIVtestingshouldberoutinelyofferedandrecommendedforallpeoplepresentingwithindicatorconditions(IC)orwithsymptomswhereanICisincludedinthedifferentialdiagnoses.

Indicator

3.4Percentageofpeoplepresentingwithindicatorconditions(IC),orwithsymptomswhereanICisincludedinthedifferentialdiagnoses,whoare

testedforHIV

Target

85%orannual

performanceincreaseof5%from

baseline/previousyear

Qualitystatement

3.5AllHIVtestingshouldbedeliveredaspartofanintegratedtestingprogrammeincludinghepatitisBandCtestingwhereappropriate;TBandSTItestingshouldalsobeincludedwhenindicated.

Indicator

Noindicator

Target

--

Qualitystatement

3.6AllchildrenpotentiallyatriskofhavingundiagnosedHIVinfectionshouldhavetheirstatusdeterminedinatimelyfashion.

Indicator

3.6PercentageofHIVexposedinfantswhohaveadocumentedvirologicalHIVtestresultwithin6weeksofbirth

Target

95%

Qualitystatement

3.7HIVtestingpromotionshouldbepartofacombinationHIVpreventionapproach.

Indicator

Noindicator

Target

--

Qualitystatement

3.8HIVtestingpromotionmessagesandcommunicationsstrategiesshouldbeadaptedforthedifferenttargetpopulationsanddesignedtoreachpeoplewithHIVwhodonotknowtheirstatusandthoseatongoingrisk.

Indicator

3.8PercentageofnationalHIVtestingpromotionstrategiesthataretargetedtokeypopulations

Target

95%

Qualitystatement

3.9Participationofcommunitymembersandkeypopulationsshouldbeencouragedinallstepsofthetestingprocessfromdemandcreationanddesigningofservicestoencouragementofserviceutilisationandengagement.

Indicator

3.9aPercentageofHIVtestingserviceswitharecordofcommunity/keypopulationinvolvementinservicedevelopmentandaccesspathways

Target

80%

Indicator

Ifanaudithasnotbeenconducted:

3.9bPercentageofcountrieswherekeypopulationsparticipateindevelopingnationalpolicies,guidelinesandstrategies

Target

80%

*Indicatorshighlightedinboldhavebeenselectedforprioritisationinordertomaximiseacceptabilityandfeasibilityofadoptionandreportingagainstthestandards.

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4.Consent

Rationale

Opt-outtestingandindicatorcondition(IC)basedtestinghasprovenhighlyeffectivewithinhealthcaresettingstoexpandHIVtestingandprovidemoretimelydiagnosis.Theseapproachesaimatreachingpeoplewhoarein

contactwiththehealthcaresystemforotherreasons,toofferHIVtesting.Ithasbeendemonstratedthattheseapproachesincreasetestingcoverageandhavethepotentialtonormalisetestingandreducestigmatisationinhealthcaresettings,inadditiontobeingcost-effectiveinterventions[8].

Importantly,HIVtestingshouldbevoluntaryinallsituations.Asawaytoincreasetesting,guidelinesrecommendthatindividualisedpre-testcounsellingandwrittenconsentforHIVtestingshouldnolongerberequired,asbotharebarrierstoincreasingtestingcoverage[3,9].

Table4.Qualitystatements,indicators,andtargetsfortopic4‘Consent’

Qualitystatement

4.1HIVtestingshouldbevoluntaryinallsituations.

Indicator

4.1ProportionofnationalHIVtestingstrategies,guidelinesorpoliciesthatstatethatHIVtestingshouldbevoluntary

Target

100%

Qualitystatement

4.2Individualisedpre-testcounsellingandwrittenconsentforHIVtestingshouldnolongerberequiredwhenundertakingHIVtesting.

Indicator

4.2ProportionofnationalHIVtestingstrategies,guidelinesorpoliciesthatdonotrecommendpre-testcounsellingorwrittenconsent

Target

100%

*Indicatorshighlightedinboldhavebeenselectedforprioritisationinordertomaximiseacceptabilityandfeasibilityofadoptionandreportingagainstthestandards.

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5.Diagnosisandtransfertocare

Rationale

Astestingprogrammesareexpanded,animportantconsiderationistoensurepathwaysareinplacefromalltestingsitestocarefacilitiesfortimelyinitiationofcareandtreatment[3,4].

Table5.Qualitystatements,indicators,andtargetsfortopic5‘Diagnosisandtransfertocare’

Qualitystatement

5.1AllHIVtestingservices,includingthoseinthecommunityandself-samplingandtesting,shouldestablishrobust,

effectivereferralpathwayswithotherserviceproviders,includingtreatmentfacilitiesandpreventionservices*,toensuretimelyaccesstotreatmentandcareorpreventionasappropriate.Thisshouldincludetheofferofpeer

support/navigatorsandrelevanthealthinformation**

(*i.e.combinationprevention:includingcondoms,PrEP,PEP,harmreductionservices,drugtreatmentprogrammes,repeattesting)

(**canbeviawrittenmaterialprovidedbythetestingserviceorviareferral/directionstowhereapersoncanseekadditionalinformation[e.g.website,specialisedhealthcaresetting,community-basedpreventionsupportservice])

Indicator

5.1ProportionofHIVtestingserviceswithdocumentedcarepathwaystoHIVtreatmentandsupportservices

Target

SpecialisedHIVtestingservices(includingcommunity)95%

Generalhealthcareservices

undertakingHIVtesting(includingprimarycare)80%

Qualitystatement

5.2Aconfirmatorytestshouldbeofferedwithin5workingdaysofareactiveHIVtest,inordertofacilitatetimelyaccesstotreatment,careandsupport.

Indicator

5.2Proportionofpeoplehavingaconfirmatorytestwithin5workingdaysofareactiveHIVtest

Target

90%

Qualitystatement

5.3ApersonnewlydiagnosedwithHIV(i.e.withapositiveconfirmatorytest)shouldbeclinicallyassessedinlinewithNationalGuidelinesbyanHIVspecialistclinicianandofferedaccesstopeerorpsychologicalsupportwithinamaximumtimeframeof2weeksaftertheresultoftheconfirmatorytestisavailable.

Indicator

5.3ProportionofnewlydiagnosedpatientsattendinganHIVspecialist

appointmentwithin2weeksoftheirinitialHIVdiagnosis(Exclusion:peopleofferedanappointmentwithin2weekswhodecline)

Target

90%

Qualitystatement

5.4Thereshouldberobustprocessesinplacetoenablefollow-upofanynon-attendees.

Indicator

5.