Abstract

Objectives: To investigate the role of primary care in the management of HIV and estimate primary care associated costs at a time of rising prevalence.

Methods: Retrospective cohort study between 1995-2005, using data from general practices contributing data to the United Kingdom General Practice Research Database (GPRD). We analysed patterns of consultation and morbidity, and associated consultation costs, among all practice-registered patients for whom HIV positive status was recorded in the general practice record.

Results: 348 practices yielded 5,504 person years (py) of follow up for known HIV positive patients, who consult in GP general practice frequently (4.3 consultations/py, 5.2 consultations/py females in 2005) for a range of conditions. Consultation rates declined in the late 1990s from 5.2 and 7.4 consultations/py in 1995 in males and females, respectively, converging to rates similar to the wider population. Costs of consultation (GP & nurse, combined) reflecting these changes, at £100.27 for male patients and £117.08 for female patients in 2005. Approximately 1 in 6 medications prescribed in primary care for HIV positive individuals has the potential for major interaction with antiretroviral medications.

Conclusion: HIV positive individuals known to the GP now consult on a similar scale to the wider population. Further research should be undertaken to explore how primary care can best contribute to improving the health outcomes of this group with chronic illness. Their substantial use of primary care suggests there may be potential to develop effective integrated care pathways.