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P124 What is the role of general practice and the potential barriers in providing shared care for people living with HIV: a systematic review
  1. Lois Hawkins,
  2. Jackie Cassell
  1. Brighton and Sussex Medical School, Brighton, UK

Abstract

Background/introduction Traditionally hospital based GUM/HIV departments have cared for people living with HIV (PLWHIV). Due to increased survival, HIV is now a chronic disease where many PLWHIV suffer from age associated illnesses. Management by generalists for such conditions is therefore essential. Shared care, however, is variably provided. We assessed the evidence on the provision and quality of shared care for PLWHIV to inform future service provision.

Aims To collate and assess the existing literature on the role of and barriers to the GP providing shared care for PLWHIV.

Methods MEDLINE, PsycINFO and EMBASE were searched using MESH terms “HIV” or “AIDS” combined with “general practice” or “primary health care”. Empirical studies from developed countries relating to the role, involvement or barriers of GP utilisation in shared care were used. Eleven research articles were eligible for this review.

Results Most GPs and patients want to engage in shared care. 81–89% PLWHIV were registered with a GP and 78% had disclosed their status. Potential barriers included lack of specialist knowledge, accessibility, issues of confidentiality and stigmatisation, and poor communication between services. GP engagement was dependent on their experience with HIV, local prevalence of HIV and patient level of morbidity.

Conclusions This review demonstrated large variations between UK health service provisions for PLWHIV. Disclosure to GPs has improved in the post-HAART (highly active antiretrovirals) era; however remaining barriers to shared care, primarily communication between services, needs to be addressed. Further research to develop models of shared care for PLWHIV is necessary to provide comprehensive safe, good quality care.

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