By reflecting on current practice, the paper by Evans et al1 revisits a much-needed discussion about expanding HIV testing in UK general practice and the role of general practitioners (GPs) in the care of HIV-positive individuals (see page 520).

Discussions around shared care of HIV patients between specialists and GPs started with the introduction of highly active antiretroviral therapy (HAART) in the 1990s; people with HIV are becoming more stable and healthier, and like many long-term conditions, HIV can potentially be managed in primary care.2 One large HIV centre in central London audited their caseload and found at least a third of patients on HAART and 80% of those not on HAART and stable could have been managed by nurse practitioners or GPs; this has huge potential for freeing up capacity in busy urban clinics.3

However, this is a paradigm shift …