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Find out if you've put yourself at risk by answering these ten simple questions from HIV Aware: www.hivaware.org.uk/be-aware/at-risk.php

Your GP

You should be able to go for screening at your own GP surgery. 

Find your nearest GP.

Please note that tests may be limited and they may refer you to a local sexual health (GUM) clinic for further specialised screening.

Aconbury North - Sexual Health Clinic

The Aconbury North - Sexual Health Clinic provides a free and confidential service to people of all ages and backgrounds. 

Where to find us

Aconbury North - Sexual Health Clinic
Aconbury North,
Newtown Rd,
Worcester
WR5 1JG 

0300 123 1731

Arrowside Unit

HIV point of care testing is now available at the Arrowside Unit in Redditch for the early detection of HIV. 

This is a rapid finger-prick screening test which allows patients to obtain a first line reactive or non-reactive HIV result within 60 seconds. 

Please contact the Health Adviser at Arrowside if you would like more information.

Where to find us:

Alexandra Hospital
Woodrow Drive
Redditch
B98 7UB

01527 516 398

www.hacw.nhs.uk/knowyourstuff/

Drug and alcohol services

If you are engaged in drug and alcohol services you may be able to access blood borne virus screening.

Worcestershire Pathways to Recovery

St Pauls Hostel – Worcester

Maggs Day Centre – Worcester

Other health services

You may be offered a test by another health care team that you already access within the hospital if they deem you to be at risk.

If this is not offered and you feel you have put yourself at risk of any blood borne virus please ask them for advice.

If you have recently been diagnosed there could be a lot on your mind.

These pages contain lots of useful and reliable information about your treatment and any worries you may have.

Remember you are not alone - we're here to help.

HIV is blood borne virus that can now be managed effectively with regular care, monitoring and treatment. The outlook for people with HIV in the UK is good, and with care/treatment engagement can lead to a good chance of living a healthy life with a near on normal life span.

If you are worried about confidentiality, you can clear your browsing history after visiting our website.

​Hospital travel and parking information.

When you arrive you will need to book in at reception in the given clinic area.  The receptionist will ask you for some personal identification details, including your GP, and a current contact number, so we can contact you in the future.

You will then be called by one of our outpatient nurses who will perform general health checks. These include blood pressure, pulse, weight and urine tests.  

Depending on your appointment type, you will see either the consultant, doctor or the clinical nurse specialist.  As this is your first visit or transfer from another centre, it may take a little longer than future appointments, as a full medical assessment and examination will be carried out. 

Blood tests will also be taken, and a full explanation of treatment and procedures will be given. During your first appointment, staff will take the time to explain how you will be cared for within our service.

We encourage you to ask questions if you are unsure of any part of your care. 

Condoms will be available within the clinics, please ask if these are not offered to you. If you have any specific requirements please ask the nursing staff. You will also be given information regarding post exposure prophylaxis (PEP) and where to go locally if this service is required.

We are specialised in this field, enabling confidentiality and continuity of care. Sometimes medical students may be present in clinic, please let us know before your consultation if this is a problem for you.

Following your visit and with your consent, we will send a letter to your GP to inform them of your progress. We encourage all of our patients to register with a GP to enable access to health care services not provided by our HIV team.

Please note that your GP provides a fully confidential service.

You will be given a follow up appointment slip either by the consultant or nurses to arrange your next appointment, which can be done by the reception staff within the clinic area before you leave.  Information and support is available outside of your appointments. Please contact us, or other linked health care professionals and support services, if you need to.

Blood tests will be taken either two weeks before you see your consultant by the specialist nurse, or on the same day as you see your consultant for review.

If you have your bloods taken on the same day as your consultation, you will only be contacted if blood results require further action.

If you require your results before your next appointment, please contact the clinical nurse specialists.

You will have baseline bloods taken every three to six months when you are established within the service. These may be repeated more frequently when you are initially diagnosed.

Tests taken include full blood count, biochemistry, renal functions, liver functions, CD4 and HIV viral load.

Annual screening will take place for Hepatitis A, B, and C and syphilis.

Other individualised tests may be requested by the consultant and these will be discussed with you.

If you have any queries regarding your blood results please discuss these with the doctors at the time of consultation, or with the clinical nurse specialist.

Follow up appointments

You will receive a letter for Consultant and Clinical Nurse Specialist appointments, also a text reminder 7 days and 2 days prior to your appointment ( Unless you are under the Hereford service which does not send standard texts.) If you would like to discuss this further, please contact your Clinical Nurse Specialist or Secretaries on 01562 512312.

Blood tests

Blood tests are taken at least every six months. 

At your consultant appointment

If you have your blood tests taken on the same day as your doctor’s appointment, you will only be contacted if there is any action to be taken on the results.

At a clinical nurse specialist appointment

You can ask to have your blood tests two weeks before your appointment with the doctor. The results will then be available at your appointment.

Please let us know if you would like to have your tests done in advance.

If you want to know your results before your next appointment, please contact the clinical nurse specialists.

Blood test screening for hepatitis A, B and C is taken at least once a year.

We advise all our patients at diagnosis and at least once a year, to have full sexual health screening at a GUM or Sexual Health Centre.

Diet and nutrition assessment

A cardiovascular and osteoporosis risk assessment is taken once a year by our specialist dietician, who can also provide you with dietary advice. 

Prescriptions and home delivery

You may be given a prescription to be picked up within the hospital or nearest hospital pharmacy.

Once you are settled on your treatment you can use the home delivery service for your HIV medication. 

Please speak to clinical staff to arrange this.

The home delivery service will only be provided to those who regularly attend their hospital appointments, and may be withdrawn if attendance or adherence to medication is poor.

BHIVA treatment guideline summaries

BHIVA (the British HIV Association) is an organisation that represents healthcare professionals working in HIV in the UK. Its guidelines set out the medical and other care people living with HIV can expect to receive in the UK.

These patient-friendly versions of BHIVA guidelines were commissioned by BHIVA and produced by nam.

HIV treatment for adults

• Starting treatment

How people cope with being diagnosed with HIV, as well as with treatment, varies from person to person.

By properly managing your condition – taking your medication correctly and avoiding illness – you will be able to live as normal a life as possible.

Other issues to consider include getting psychological support, telling people about your HIV, pregnancy and financial support.

Men's health

At your appointments we will check and talk about your general health.  

Anything related to the HIV virus will be addressed. Your GP may have to manage some conditions and refer you to specialist services if required.  

Staff in the clinic will also talk you through your care pathway.

We advise to attend sexual health for a regular sexual health screen if sexually active, and if you have any concerns to discuss with the Clinical Nurse Specialist at your hospital appointment.

Annual screening that is carried out within our outpatient clinics includes Hepatitis A, B and C and syphilis as per BHIVA guidelines. A brief mental health assessment will also be obtained each year from all patients.

Condoms are available to patients when visiting clinics. If they are not already offered, please ask or telephone the clinical nurse specialists.

Women's health

It is important that you have a cervical screening test (smear test) once a year.

This is because women with HIV have a slight increased risk of cervical abnormalities.

Smear tests should be provided by your GP practice, but in certain circumstances these may be provided by the clinical nurse specialist within the clinic.

Protecting yourself and others

Contraceptive advice can only be given within the clinic setting, and referral for specialist advice can be provided.  Contraceptives can be prescribed by your GP or local sexual health clinics. 

Condoms can be provided within clinic.

Clinic appointments

At your appointments we will check and talk about your general health.  

Anything related to the HIV virus will be addressed. Your GP may have to manage some conditions and refer you to specialist services if required.  

Staff in the clinic will also talk you through your care pathway.

We advise to attend sexual health for a regular sexual health screen if sexually active, and if you have any concerns to discuss with the Clinical Nurse Specialist at your hospital appointment. .

Annual screening that is carried out within our outpatient clinics includes Hepatitis A, B and C and syphilis as per BHIVA guidelines. A brief mental health assessment will also be obtained each year from all patients.

Condoms are available to patients when visiting clinics. If they are not already offered, please ask or telephone the clinical nurse specialists.

Nutrition

At most clinics a dietitian is available to offer advice and support with any dietary needs. Annual assessments are offered for prevention of cardiovascular disease and osteoporosis.

Eating a well balanced diet is important for everyone, food provides us with the energy and essential nutrients for the cells to grow, maintain and repair. Having the right nutrients help us fight against infection and keep are immune system strong.

People living with HIV may experience various symptoms at different times. Some people who are newly diagnosed with HIV may experience weight loss as a result of a decreased appetite, nausea, oral thrush and sometimes bloating or diarrhoea. At other times a low mood or drug interaction can also affect your appetite. If you have poor appetite or have experienced weight loss your dietitian will be able to give advice on food enrichment and supplementation. 

It has now been recognised that HIV is an independent risk factor for cardiovascular disease. The virus causes an increase risk of fatty substance (atherosclerosis) build up and some medication can affect fat distribution and cholesterol levels. Other lifestyle factors such as smoking and obesity increase your risk of cardiovascular disease. Your dietitian can advise you on healthy eating for your heart, discuss lifestyle and weight management. 

Your dietitian can also discuss your bone health and give you advice on adequate intake of calcium and Vitamin D.

Do I need to take supplements?

If you eat a balanced diet there is no clinical evidence that additional vitamins or minerals are beneficial, unless you have been advised by your doctor that you require supplementation for a specific medical condition.

Holistic medication should be checked with one of the team to ensure there is no drug interactions with you medication.

When you are first diagnosed with HIV it is very difficult to decide who you wish to know and who needs to know your diagnosis. The decision is very much up to you.

If you are unsure who to tell, we can offer you advice and support to help make the right decision for you.

The useful links to the right may help you to decide who you want or need to tell.

Disclosure of HIV status and criminalisation

To date there have been 14 prosecutions of adults under Section 20 of the 1861 Offences Against the Persons Act for 'reckless transmission' of HIV when condoms were not used consistently.

Prosecution technically requires the four following criteria to have been met. However, prosecution procedures have been known to commence while proof is being established.

• You had sex with someone who didn’t know you had HIV 

• You knew you had HIV at that time  

• You understood how HIV is transmitted  

• You had sex without a condom  

• You transmitted HIV to that person

A HIV-positive individual should ideally disclose their status to sexual partners even when they are having protected sex. This will allow partners to make their own risk assessment and will ease discussions about post exposure prophylaxis for sexual exposure (PEPSE).

If a HIV positive individual is having unprotected sex or there has been a risk of exposure (e.g condom splits) they need to disclose their HIV status to that partner so that they can obtain PEPSE to lessen the risk of HIV transmission.

A HIV positive individual need to be aware of the law, how they can stay within it and, what behaviour may be interpreted as breaking the law.

Education around HIV and onward transmission is a continuous process, if you would like advice or support around this issue, please do not hesitate to contact the team. CPS guidance states that, 'appropriate and reasonable safeguards' are a defence. It is not clear, however, on what happens if a condom breaks, and around oral sex.

If an allegation is made against you, early discussion with specialist agencies such as NAT, THT, HYPNET, CHIVA, BASHH or BHIVA is advised.

Further guidance is available from the NAT / THT Document on criminalisation 2009.

Medication

Anti-HIV drugs are referred to as HAART (Highly Active Antiretroviral Therapy), ART (Antiretroviral therapy) or triple therapy.

You may be prescribed this medication once the amount of CD4 (infection-fighting cells) in your blood, or your general health, show that you need to start treatment. 

You can also be prescribed this medication if you have a partner who is HIV negative.

Different medication works better for different people. Your blood test results will help us decide which is right for you.

HIV treatment only works if you take your pills on time, every time.  Missing even a few doses will increase the risk of your treatment not working.

Side effects

You may experience some side effects when you first start treatment.  We will let you know what signs or symptoms to look out for. 

If symptoms continue, it is important that you let us know so we can make changes to your treatment to reduce any problems. 

Don’t suffer in silence, we can help you manage side effects.

Different people experience different side effects, some do not have any at all.

Vaccination

Some vaccinations will be offered to you in clinic, these include:

• Hepatitis A vaccine

• Hepatitis B vaccine

Learn more about our Hepatitis services.

We will ask you to have further vaccinations from your GP, including the seasonal flu vaccine.  All travel vaccines must be given by your GP. Live vaccines should not be given.

Please ask us or your GP if you are unsure. 

If you have recently been diagnosed with HIV, or wish to transfer your care to the Worcestershire area, you will be able to access either Worcestershire Royal Hospital, Kidderminster Hospital and Treatment Centre or Arrowside Unit, Redditch clinics.

Pre-arranged appointments are necessary as a drop in service is not available.

If you have recently been diagnosed via sexual health services, your GP or by another health professional services, they should arrange an appointment for you to attend one of our clinics as soon as possible to ensure optimum care can be provided to you. If this has not been done please contact our secretary on 01562 513072, who will be able to liaise with our local services to arrange this.

If you wish to transfer your care to our area, please again contact our secretary to arrange an appointment. You may be asked to provide information about your previous care centre so that vital information can be transferred to us.

Don't pass it on

The risk of passing on HIV with any type of sexual activity varies based on on how often that activity is carried out, multiplied by the risk per exposure and other factors.

The most common route of transferring HIV worldwide remains heterosexual sex.

The table below illustrates the risks associated with different sexual acts, which should be considered in context.

Type of sex act - Risk of transfer

Receptive vaginal - 1 in 1000 (0.1%)

Insertive vaginal - 1 in 2000 (0.05%)

Receptive anal - 1 in 200 (0.5%)

Insertive anal - 1 in 1538 (0.065%)

Receptive oral with ejaculation - 4 in 1,000,000 (0 ~ 0.0004%)

How HIV can be passed on

Blood products that are not screened for HIV 
The NHS tests every blood donation for HIV.

Mother to child transmission 
This can be prevented if women are aware of their status and receiving HAART (anti-HIV medication).

Shared needles for intravenous drug use

Unprotected sex 

Anal rather than vaginal sex carries a greater risk per exposure. 

Anal sex is practised by both (MSM) and some heterosexuals. 

Condom use for anal sex is always recommended. 

During unprotected vaginal sex HIV passes more easily from men to women than from women to men. 

Unprotected oral sex

Oral sex is less risky than anal or vaginal sex but is not risk-free – condoms or dental dams can be used.

Good adherence to HAART medication regimens is vital in order to reduce the risk of transferring HIV by maintaining an undetectable viral load.

What increases the risk?

• High plasma and genital secretion HIV viral load due to:

  • Primary HIV infection
  • Advanced untreated HIV diseases

• Other sexually transmitted infections – especially ulcerative conditions

• Menstruation

• Trauma (for example due to non-consensual sex)

What decreases the risk?

• Condoms
• Male circumcision
• Good use of HAART medication

• Is it safe to stop using condoms?

Current opinion in the UK is that it is not safe to stop using condoms as there may still be a small risk of transmitting HIV through sex.

This is because the amount of HIV virus measured in the blood may not reflect the amount in semen or the genital tract, which can be higher.

Individuals with undetectable amounts of the virus occasionally show ‘blips’ when the amount rises to detectable levels. This can cause transmission to occur during one of these undetected ‘blips’, which an you might not be aware of.

• Have you put someone at risk?

If you feel you have put a partner at risk of HIV infection, either by having unprotected sex, an accident with a condom, or any other risk activity, it is your responsibility to ensure that they know your status and that you advise them to get post exposure prophylaxis therapy. 

In the Worcestershire area this can be provided by GUM services (Arrowside and John Anthony Centre) or at Worcestershire Royal Hospital's A&E.

This should be done as soon as possible - ideally within 72 hours.

If you are planning a pregnancy or are pregnant, it is essential that you inform your HIV consultant or clinical nurse specialist as soon as possible.

This makes sure that we can give you and your baby the best possible care and reduces the risk of passing on HIV to your baby. 

Local antenatal services are available in the Worcestershire area. 

We have midwives and consultants who specialise in the care of pregnant women with HIV.

Support

Although we do not have psychological services specifically within our team, in certain circumstances our consultants or clinical nurse specialists can refer direct to specialised counselling.

Advice can also be given on how to access support services. 

Please ask in clinic if you feel that you may benefit from counselling services.

Urgent psychological support should be accessed via your GP who has immediate access to services when required.

Please ensure that you allow plenty of time for parking and checking into the clinic.

Your appointment may take longer than expected if you need to see more than one member of the team.

Where to find us

Arrowside Unit, Redditch

The Arrowside Unit, situated next to the Alexandra Hospital, provides an outpatient clinic every six to eight weeks.

The Arrowside Unit is also able to provide a full sexual health screening service.

Consultation is by appointment only.

Kidderminster Hospital and Treatment Centre   

The HIV clinic runs every Wednesday morning situated in the Outpatients Department, Level 1, Kidderminster Treatment Centre.

Please report to reception on arrival.

Consultation is by appointment only.

Worcestershire Royal Hospital 

The HIV clinic runs every Thursday morning in Sorrel Suite within the outpatient department at Worcestershire Royal Hospital.

Consultation is by appointment only.

We have a dedicated team of specialist nurses, consultants, pharmacists and dietitians to look after you when you are in our care.

Consultants

Dr Mark Roberts, Consultant Physician in Infectious Diseases

Dr Mirella Ling, Consultant Physician in Infectious Diseases

Dr Okunsukwa, Sexual Health Consultant

Dr Seppings, Sexual Health Consultant 

HIV nurse specialists

Sam Green, Clinical Nurse Specialist (Based at Kidderminster)

Dietitians

Jo Maguire, Dietitian

Pharmacists

Clinical and Clerical Support 

Joanne Dando, Clinical and Clerical Support

Jayne Andrews, Clinical and Clerical Support 

Secretaries

It's a fact! U=U Undetectable = Untransmittable leaflet available for more information.

Read: How we're supporting patients from the LGBTQ+ community - As a team, we very much support this. and feel this is very relevant to our service users.