Experience of primary care for people with HIV: a mixed-method analysis

Background: Advances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs. Aim: To explore the experience of people living with HIV (PLHIV) regarding consulting their GPs. Design & setting: A mixed-method an...

Full description

Bibliographic Details
Main Authors: Tanvi Rai, Jane Bruton, Meaghan Kall, Richard Ma, Erica Pufall, Sophie Day, Valerie Delpech, Helen Ward
Format: Article
Language:English
Published: Royal College of General Practitioners 2019-12-01
Series:BJGP Open
Subjects:
hiv
Online Access:https://bjgpopen.org/content/3/4/bjgpopen19X101665
id doaj-5538aed3f6f64296a0c317a9789ff65c
record_format Article
spelling doaj-5538aed3f6f64296a0c317a9789ff65c2020-11-25T01:11:21ZengRoyal College of General PractitionersBJGP Open2398-37952019-12-013410.3399/bjgpopen19X101665Experience of primary care for people with HIV: a mixed-method analysisTanvi Rai0Jane Bruton1Meaghan Kall2Richard Ma3Erica Pufall4Sophie Day5Valerie Delpech6Helen Ward7Research Associate, School of Public Health, Imperial College London, London, UKClinical Research Manager, School of Public Health, Imperial College London, London, UKPrincipal Scientist, HIV/STI Department, National Infection Service, Public Health England, London, UKGeneral Practitioner and NIHR Doctoral Research Fellow, School of Public Health, Imperial College London, London, UKResearch Associate, School of Public Health, Imperial College London, London, UKVisiting Professor of Anthropology, School of Public Health, Imperial College London, London, UKHead of HIV Surveillance, Public Health England, London, UKProfessor of Public Health, School of Public Health, Imperial College London, London, UKBackground: Advances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs. Aim: To explore the experience of people living with HIV (PLHIV) regarding consulting their GPs. Design & setting: A mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV. Method: Univariate logistic regression was used for quantitative data and framework analysis for qualitative data. Results: The survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment. Conclusion: The authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.https://bjgpopen.org/content/3/4/bjgpopen19X101665hivhiv infectionschronic diseasegeneral practiceempathypatient satisfactionsocial stigmasurveys and questionnairesqualitative research
collection DOAJ
language English
format Article
sources DOAJ
author Tanvi Rai
Jane Bruton
Meaghan Kall
Richard Ma
Erica Pufall
Sophie Day
Valerie Delpech
Helen Ward
spellingShingle Tanvi Rai
Jane Bruton
Meaghan Kall
Richard Ma
Erica Pufall
Sophie Day
Valerie Delpech
Helen Ward
Experience of primary care for people with HIV: a mixed-method analysis
BJGP Open
hiv
hiv infections
chronic disease
general practice
empathy
patient satisfaction
social stigma
surveys and questionnaires
qualitative research
author_facet Tanvi Rai
Jane Bruton
Meaghan Kall
Richard Ma
Erica Pufall
Sophie Day
Valerie Delpech
Helen Ward
author_sort Tanvi Rai
title Experience of primary care for people with HIV: a mixed-method analysis
title_short Experience of primary care for people with HIV: a mixed-method analysis
title_full Experience of primary care for people with HIV: a mixed-method analysis
title_fullStr Experience of primary care for people with HIV: a mixed-method analysis
title_full_unstemmed Experience of primary care for people with HIV: a mixed-method analysis
title_sort experience of primary care for people with hiv: a mixed-method analysis
publisher Royal College of General Practitioners
series BJGP Open
issn 2398-3795
publishDate 2019-12-01
description Background: Advances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs. Aim: To explore the experience of people living with HIV (PLHIV) regarding consulting their GPs. Design & setting: A mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV. Method: Univariate logistic regression was used for quantitative data and framework analysis for qualitative data. Results: The survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment. Conclusion: The authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.
topic hiv
hiv infections
chronic disease
general practice
empathy
patient satisfaction
social stigma
surveys and questionnaires
qualitative research
url https://bjgpopen.org/content/3/4/bjgpopen19X101665
work_keys_str_mv AT tanvirai experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT janebruton experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT meaghankall experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT richardma experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT ericapufall experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT sophieday experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT valeriedelpech experienceofprimarycareforpeoplewithhivamixedmethodanalysis
AT helenward experienceofprimarycareforpeoplewithhivamixedmethodanalysis
_version_ 1725171536389734400