14th Annual Conference of the British HIV Association 23–25 April 2008, Belfast

UNDERSTANDING THE BARRIERS TO GP INVOLVEMENT IN THE CARE OF PATIENTS WITH HIV

HIV Med 2008; 9(Suppl. 1):2 (abstract no. O6)

M Kennedy¹, Y Gilleece¹, N Perry¹, A Cressey¹, J Wastie², H Smith¹ and M Fisher^1
1Brighton and Sussex Medical School, Brighton, UK, ²St Peter’s Medical Practice, Brighton, UK

BACKGROUND: Studies in the pre-HAART era identified numerous patient barriers to the involvement of GPs in their care. Little data exists in the post-HAART era, although primary care is likely to become increasingly important as HIV patients live longer and experience diseases of old age.

METHODS: Following piloting, a questionnaire exploring GP involvement was offered prospectively to all patients from Mar–May ’07 attending a HIV outpatient clinic. Barriers defined using a Likert scale in response to a series of statements.

RESULTS: Of 475 patients offered, 222 responded. 92% (205) male, 86% (191) white and 84% (186) homosexual/bisexual. 93% (207) had registered with a GP and 84% (174) had disclosed their HIV status to their GP. Confidentiality (50% 103), discussing (57% 117) or being judged for lifestyle choices (60% 124) were not barriers for the majority of patients registered with a GP. 38% (78) identified a lack of GP HIV knowledge and experience as barriers to involvement in their care. Patients who had disclosed their HIV status felt comfortable with their GP managing HIV-related problems (50% 87) and the GP’s understanding of HIV drug interactions (48% 81) and side effects (46% 78). Barriers perceived by patients who had not disclosed their status to their GP included discussing lifestyle choices (42% 10), confidentiality (58% 14), lack of GP knowledge (52% 12) and experience of HIV (61%14).

CONCLUSIONS: This study showed a much higher level of GP involvement compared to pre-HAART studies suggesting that a high level of primary care is achievable. Barriers still remain however for a significant minority of patients. These include a perceived lack of GP knowledge and experience of HIV and the issue of confidentiality. Secondary care providers need to work with patients and primary care to address these issues.

*Data from Abstracts O6 and P2 merged into one oral presentation and no poster will be displayed at the conference.

2008-04-23
O6

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