A new UK study has looked into the quality of care that people with HIV receive from their GPs. In the UK, HIV-related care is always handled by specialist doctors at hospital clinics, but people living with HIV also need to see GPs (general practitioners) for other aspects of their health care.
The study combined the findings of a nationally representative survey of over 4000 people with HIV and in-depth qualitative interviews with another 52 people living with HIV.
It found that 98% of people were registered with a GP. However, most participants felt obliged to register with a GP because this was recommended by their HIV clinic and it was the only way to receive services such as statins, flu vaccines and smear tests.
About two-thirds of participants thought their GP had sufficient knowledge of HIV (65%), had an appropriate level of involvement in HIV care (65%) and that specialist HIV services and GPs communicated well (64%). Slightly fewer felt comfortable asking their GP HIV-related questions (59%).
The interviews highlighted difficulties that have been reported many times before, including concerns about confidentiality; GPs who had a lack of knowledge or confidence in relation to HIV; and doctors who place an excessive emphasis on HIV as a cause of health problems.
But the interviews also revealed some examples of good practice. One man said:
“I then found a GP, which was not far from me, which was great. I went in there, with my carer with me and I said, ‘This is what’s happening.’ He said, ‘That’s okay, let me see what I can do to make life easier.’ I’ll never forget him saying that.”
Another man said:
“They didn’t really know what to do initially, but then I got a phone call that there’s a specific doctor that deals with HIV cases within the surgery. So, they’ve been good.”
The researchers say that other GP practices which care for several people with HIV should identify a doctor who proactively shares their knowledge of HIV with colleagues. They recommend that GPs should receive regular updates about HIV, and also display information about HIV in their surgeries, for instance on testing or U=U, in order to help allay fears regarding stigma.
The researchers recommend that GPs clearly explain what they do to protect confidentiality. Explicit consent should be sought each time a GP needs to share information about a patient.
They point out that the issues people with HIV face with GPs are similar for patients with other long-term health conditions. These include fragmented and uncoordinated care as well as a lack of emotional support. But the researchers say that GPs could improve the care they provide to people with HIV by using skills – especially those relating to empathy and person-centredness – that they have developed when looking after people with other long-term conditions.
For more information, read NAM's page 'GPs and primary care'.