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People living with HIV in the UK live long and healthy lives and, as HIV is now a chronic health condition like many others, the role of primary care in HIV is pivotal.

Primary care has an important role in:

• testing for HIV to help identify new diagnoses;
• advising on preventative treatments (PrEP and PEP);
• linking people living with HIV into secondary care; and
• managing various aspects of HIV such as vaccines, preventative healthcare, and common co-morbidities. 

HIV testing

HIV can affect anyone, regardless of age, gender, sexual orientation, or ethnicity. Additionally, all of London is an area of high or very high HIV prevalence. 

This means that, as per NICE Guidelines, it is recommended to test for HIV when a patient:

• has symptoms that may indicate HIV or has risk factors for acquiring HIV;
• newly registers with a practice; and/or
• is undergoing blood tests for another reason and has not had an HIV test in the previous year. 

See the HIV testing page for more information. 

Referral options

If a patient tests positive for HIV, it is the responsibility of the GP to inform the patient of the result and refer them to the HIV clinic of their choice.

HIV as a chronic health condition

People living with HIV are at increased risk of certain co-morbidities including cardiovascular disease, osteoporosis, diabetes and frailty.

Once patients are established on treatment, HIV care within primary care includes:

1. Vaccines: annual flu vaccine, PCV-13 on diagnosis of HIV, PCV-23 if at risk
2. Cardiovascular risk: statins recommended for everyone aged 40 and older
3. Cancer risk: smear test yearly for people with a cervix aged 25 to 64
4. Osteoporosis risk: FRAX score every 3 years
5. Medications: list anti-retroviral medication on patients’ medical file and assess for drug interactions as needed (see Liverpool HIV Interactions (hiv-druginteractions.org)