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Getting to grips with testing children: protocols and procedures. Justin Daniels North Middlesex Hospital December 2008. National Guidance. UK National Guidelines for HIV Testing 2008
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Getting to grips with testing children: protocols and procedures Justin Daniels North Middlesex Hospital December 2008
National Guidance • UK National Guidelines for HIV Testing 2008 • Any infant/child/young person thought to be at significant risk of HIV infection, including all those with parents or siblings who are HIV-infected, should be tested. It is in the best interest of the infant /child/young person to be tested in these circumstances although this only needs to be undertaken urgently in infants who are at risk of rapid disease progression.
The need for a clearer system • How to translate this into action • Adult tests positive • Many factors • We need to ensure children feature in this
So far… • Protocol for referral • Information leaflet – why your child needs a test • Closer working between adult and paediatric team • Clear guidance from social services
Positive male • Does he have children? • Does his partner know his diagnosis? • Risk assessment • Discuss with social services if necessary
Positive child / Indeterminate baby • Do we know the status of all the other children in the family? • Record names and dates of birth • Where were they tested? • If any doubt check and if necessary repeat
Looking backwards • What do we know about adults under our care? • What do we need to find out? • How do we record this information?
Enabling this to happen • Easier if coordinated adult and paediatric HIV teams • If not – networks / shared protocols • Importance of voluntary sector • Inertia not an option!
How have we done? • Several families reluctant • All have been amenable to persuasion • No referrals to social services so far!