TARGET ID Phase 2: Digitally Targeted Testing for Blood-borne Virus Infections

HIV, hepatitis B, and hepatitis C are viruses that can be passed on through blood or sexual contact. If not treated, they can lead to serious liver disease, cancer, and even death. Many people in the UK do not know they are living with one of these viruses.
These infections particularly affect:
• Men who have sex with men
• People from ethnic minority backgrounds and migrants
• People who inject drugs
• People experiencing homelessness
• People in prison
Many of these groups face barriers to healthcare-such as difficulty accessing GP services, language barriers, fear of discrimination, or unstable housing. This means they are less likely to get tested and treated, leading to worse health outcomes and widening health inequalities (where some groups of people have worse health than others).
Testing everyone in the population would be wasteful and expensive, as most people are not at risk. It would also only test for one virus at a time. We need better ways to identify and support people who would most benefit from testing.
In this project, we are working with people who have lived experience of these infections to make sure our approach meets the real needs of those affected.
Together, we are creating a programme that
• identifies people who would most benefit from testing, so testing is more focused and efficient
• Offers testing in a way that people find acceptable and respectful
• Ensures people who test positive get the care and treatment they need
What we have done so far (funded by the School for Primary Care Research).
• Reviewed existing research on how GP computer systems can help identify people at higher risk of these infections.
• Created comprehensive lists of medical codes that GPs use to record these infections and related risk factors in patient records.
• Used computer analysis to identify which factors in GP records are most strongly linked to these infections, using anonymous healthcare data from general practices in North East London.
• Developed a simple risk score that estimates whether someone might benefit from testing, based on information already in their GP record. The score ranges from very low to very high risk. We started using data from East London and are now testing the system with data from other parts of the UK.
• Worked closely with people who have lived experience of these viruses to design the best way to invite people for testing. We want to make sure people understand how testing is offered and that we approach those who might benefit in a respectful and acceptable way.
• Begun testing the programme in six GP practices (two each in London, Bristol, and Leicester). We are collecting feedback from patients and staff and will make improvements to ensure the programme is user-friendly and good value for money.

GP - We will require data from people diagnosed with or at risk of infection with blood-borne viruses, including HIV, Hepatitis B and Hepatitis C. This will include demographic data such as age, ethnicity, gender and IMD scores; and risk factors such substance use, sexual orientation, imprisonment, homelessness, and HIV/AIDS associated conditions. We will provide the complete SNOMED code sets for both CASES (those with the infection) and RISK FACTORS.

Dr Werner Leber, Queen Mary University of London

Professor Chris Griffiths, University of Oxford

Dr John Robson, Queen Mary University of London

Mr Andrew Snelling, Queen Mary University of London

Professor Julia Hippisley-Cox, Queen Mary University of London