The UK is facing a public health crisis because the government is not doing enough to prioritise HIV services, according to a report prepared by the professional body representing HIV clinicians and an HIV charity.
The report, published by the British HIV Association (BHIVA) and the Terrence Higgins Trust (THT) canvassed HIV doctors' opinions about the government’s HIV and sexual health strategy, which was published in draft form nearly a year ago, with the finalised version expected shortly. In particular, HIV specialist doctors’ views about general practice physicians providing HIV care were sought.
The report highlights a near doubling of new HIV diagnoses between 1995 and 2001. According to figures from the Public Health Laboratory Service, which gathers UK government statistics on HIV, there are now an estimated 33 000 people with HIV in the UK. The BHIVA/THT report suggests that specialist HIV clinics are buckling under the strain of treating not only the newly detected cases of HIV, but the many people living longer, healthier lives thanks to the success of HAART.
Worryingly, increased numbers of HIV infections are having the knock-on effect of longer waiting times for people seeking treatment for sexually transmitted infections (STIs), with a over a quarter of people waiting up to 14 days for treatment and 2% up to three months for an appointment. It is recommended that treatment for STIs is provided within 48 hours of symptoms first appearing, not least because an untreated infection can increase the chances of an HIV-negative person picking up the virus and a person with HIV passing it on. In recent years rates of gonorrhoea in the UK have more than doubled and there have been syphilis outbreaks, mainly affecting gay men, in London and other UK cities.
Nor, the report suggests, will government plans to devolve the management of people with HIV to general practices resolve the impending crisis. Whilst HIV doctors believe that there is increased scope for HIV testing in general practice, they describe primary care as inappropriate for the management of HIV disease. Dr Margaret Johnson of BHIVA said: ‘HIV management is very complicated and not appropriate for GPs.’
Calling the draft sexual health and HIV stratey a 'missed opportunity', Dr Johnson called for more information about the role the government wanted primary care trusts (PCTs) to play in HIV care, particularly as the report also suggests that PCTs are moving funds away from HIV services to pay for other government health priorities.
Professor Brian Gazzard, BHIVA chair and director of HIV research at the Chelsea and Westminster Hospital, home of the UK’s largest HIV clinic, said that the only solution to the problem of overloaded HIV and STI services was ‘the provision of more money and facilities.’