Developing new models of shared primary and specialist HIV care in the UK: a survey of current practice

Hutchison Jane, Lorna J. Sutcliffe, Williams Andy J, Claudia Estcourt

Research output: Contribution to journalArticle

Abstract

HIV care in the UK is led by hospital-based specialists with limited general practitioner (GP) involvement. As GPs have expertise in some non-microbial HIV-associated co-morbidities (e.g. cardiovascular disease), and more people are
disclosing their HIV status to their GPs, there could be benefits in sharing HIV care. We describe contemporary models of shared HIV care in relevant developed world settings to inform future shared HIV care in the UK. An interview survey of key informants was used to explore experiences and models of shared care, and identify promoting and inhibiting factors. We interviewed ten key informants from six shared care models. There were three broad categories of shared care, with varying degrees of GP involvement. Strong clinical leadership in primary care, good professional relationships and communication, and tailored GP training were facilitators. Barriers included stigma, confidentiality concerns, and low prevalence of HIV outside major conurbations. Contemporary shared HIV care
models have emerged organically and seem to work when grounded in good collaboration between a small number of dedicated GPs and specialist units. We propose two models for further study which may only be feasible in high HIV
caseload practices. User acceptability, clinical and cost effectiveness must be considered.
Original languageEnglish
Pages (from-to)617-624
Number of pages8
JournalInternational Journal of STD and AIDS
Volume27
Issue number8
Early online date24 Jun 2015
DOIs
Publication statusPublished - 1 Jul 2016

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Keywords

  • HIV
  • AIDS
  • primary care
  • shared care
  • models

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