HIV Indicator Conditions

Guidance for Implementing HIV Testing in Adults in Health Care Settings


Late diagnosis is associated with increased HIV-related morbidity and mortality, poorer response to treatment, increased healthcare costs and increased transmission rates. Therefore, there are many benefits of diagnosing HIV at an early stage, and this is why early diagnosis should be a key public health strategy. Earlier diagnosis requires innovative approaches to improve testing among those most likely to be infected with HIV and who present late for care.

This guidance proposes a novel approach, indicator condition-guided HIV testing, that should be an additional element of an overall comprehensive national HIV testing strategy.

Read the guidance here.

Find short versions of the guidance in different languages:

Albanian  -  Arabic  -  Bosnian  -  Bulgarian  -  Croatian  -  Czech  -  Danish  -  English  -  Estonian  -  Finnish  -  French  -  German  -  Greek  -  Hebrew  -  Hungarian  -  Icelandic  -  Italian  -  Lithuanian  -  Macedonian  -  Maltese  -  Norwegian  -  Polish  -  Romanian  -  Russian  -  Serbian  -  Spanish  -  Slovak  -  Slovenian  -  Swedish  -  Turkish

OptTEST Tools


The OptTEST by HIV in Europe project – Optimising testing and linkage to care for HIV across Europe – was a three-year project co-funded by the EU Commission under the Second Health Programme. The project aimed at helping to reduce the number of undiagnosed people with HIV infection in the European region and at promoting timely treatment and care. The project produced tools and assessment methods to analyze and effectively respond to late presentation for HIV care and treatment, with a particular emphasis on priority regions and groups throughout Europe. The tools are presented below.


Introduction to indicator condition (IC) guided testing:

Indicator condition (IC) based testing is an effective and efficient strategy within healthcare settings to expand HIV testing and more timely diagnosis. This is an approach where healthcare professionals routinely offer an HIV test to all individuals presenting with an indicator condition because the condition is associated with undiagnosed HIV infection. We created a slide set about late testing, barriers to testing and IC guided testing strategy that can be used to present the concept of IC guided testing to a range of audiences, e.g. decision makers. 

Download the slide set "Introduction to IC guided testing" in  English  -  French  -  Estonian  -  Polish  -  Russian  -  Spanish

"Instructions" slide set can be used by HIV clinicians and specialists in other fields who manage indicator conditions to make presentations about HIV testing to a range of audiences, e.g. decision-makers, with particular reference to the introduction of indication condition guided HIV testing.

Download the slide set "Instructions" in  English  -  French Estonian  -  Polish  -  Russian  -  Spanish

E-learning module:

As a part of OptTEST the module for non-HIV specialist healthcare professionals was developed. It aims to support providing HIV testing for people with HIV indicator conditions. 

To start learning follow the link: IC guided testing for non-HIV specialist healthcare professionals

Online planning tool:

This resource has been developed for lead clinicians or managers who are planning to introduce indicator condition guided HIV testing in their service.  It will show the operational points that should be considered while planning to start testing in the service. It will help to consider what will happen before an HIV test is offered, how testing will be done and how results will be managed. 

Go to the tool: How to set up IC guided testing in a clinic


Specialty Guidelines Review


During the OptTEST Final Conference, 19 September 2017, Brussels, Dr. Emily Lord from Oxford University Hospitals NHS Foundation Trust held a presentation about How to Enhance Provider-Initiated HIV Testing based on the review of national specialty guidelines` recommendations for HIV testing in Spain, UK, and Estonia. 

To watch the video on YouTube press here

Find also the publication by Lord E, Stockdale AJ, Maleck R et al. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions in HIV Medicine from 2016.