BHIVA Standards of Care for People Living with HIV

Glossary of terms and abbreviations

Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health and the emergence of drug resistant strains of HIV.

Adherence support: Mechanisms and interventions that help patients match the agreed recommendations, allowing them to take the correct dose of the correct drug at the correct time.

AIDS (acquired Immunodeficiency syndrome): AIDS is a clinical syndrome, characterised by an increased susceptibility to a number of infectious and malignant conditions, which is the result of damage to the immune system caused by HIV.

Antiretroviral therapy (ART, ARVs): Drugs, usually taken in combination with one another, that suppress the activity of HIV by inhibiting viral replication.

BASHH: British Association for Sexual Health and HIV (

BHIVA: British HIV Association (

CD4 cells: The class of white blood cells known as CD4 T-helper lymphocytes, which are the target cells for HIV and subsequent damage.

CD4 count: The number of CD4 T-helper lymphocytes in the blood. Someone without HIV normally has a count between 500 and 1200 cells/mm3.

Chemsex: Sex between men under the influence of drugs (typically methamphetamine, mephedrone, GHB/GBL) taken immediately before and/or during a sex session to sustain, enhance, disinhibit or facilitate the experience and performance.

CHI: Community Hospital Index number (Scotland)

CHIVA: Children’s HIV Association (

Clinical indicator condition: A specific clinical condition which is associated with HIV and in which HIV therefore enters the differential diagnosis.

Commissioning: The process of planning, agreeing and monitoring services.

Continuing Professional Development (CPD): An ongoing commitment to learning in various forms, which maintains knowledge and skills, and which enhances professional standards of work. This is an obligatory component of most professions.

CQUIN: Commissioning for quality and innovation national goals.

CSE: Child sexual exploitation

Designated: A specified place or person that is identified for a certain purpose or responsibility.

DoH: Department of Health.

DHIVA: Dietitians working in HIV/AIDS.

Drug interaction (drug–drug interaction or DDI): A situation in which a substance (often another drug) affects the activity of a drug, i.e. the effects of the drug may be increased or decreased, or a new effect may occur that neither agent produces when taken on its own.

Drug resistance: The ability of HIV to overcome the drugs used in its treatment. Other terms include class resistance and multi-drug resistance. Class resistance refers to a strain of HIV that shows evidence of resistance to one class of drug (e.g. NRTIs, NNRTIs or PIs). Multi-drug resistance usually implies resistance to multiple classes of drugs.

FRSH: Faculty of Sexual and Reproductive Healthcare (

GMC: General Medical Council (

GU or GUM: Genitourinary medicine. Medical specialty relating to the diagnosis and management of sexually transmitted infections (including HIV) and other genital conditions in men and women.

HCPC: Health and Care Professions Council (

HDU: High-dependency unit.

HPS: Health Protection Scotland (

HIV: Human immunodeficiency virus.

HIV resistance assay: An assay to identify the presence of changes within the genetic make-up of HIV which will lead to drug resistance. It is useful in deciding which HIV drugs to use to treat HIV in an individual patient.

HLA-B*5701: HLA-B*5701 is one of a family of human genes, the human leukocyte antigen (HLA) complex. This particular HLA type is associated with allergic reactions to the drug abacavir.

ID (infectious diseases): The branch of medicine that specialises in the diagnosis and management of infectious diseases.

Immunosuppression: A reduction in the activity or the effectiveness of the immune system, leaving the individual more susceptible to a range of infections.

IPV: Intimate partner violence.

ITU: Intensive therapy unit.

‘Late’ and ‘very late’ HIV diagnosis: A CD4 cell count below 350 cells/mm3 at time of diagnosis of HIV. Very late diagnosis is either clinical presentation of AIDS at time of HIV diagnosis or a CD4 cell count less than 200 cells/mm3.

LGV: Lymphogranuloma venereum: a sexually transmitted infection caused by the invasive serovars L1, L2, L2a or L3 of Chlamydia trachomatis.

Morbidity and comorbidity: The state of being unhealthy and/or having a particular disease. Comorbidity refers to the presence of all the diseases and health problems that may exist in an individual patient, in addition to HIV.

MDT/multidisciplinary team: The term ‘multidisciplinary team’ used in this document refers to a group consisting of representatives from several different professional backgrounds and areas of expertise.

MSM: Men who have sex with other men. Refers to any man who has sex with another man, whether he identifies himself as gay, bisexual or heterosexual.

Network: A collaboration between service providers to ensure that people living with HIV have equity of access to appropriate care. The network will vary depending on prevalence, cost and complexity of condition. It may involve two local services working together and be based regionally or nationally. The collaboration may involve multiple specialties working together as part of an MDT.

NHIVNA: National HIV Nurses Association (

NIHR: National Institute for Health Research. An organisation whose aim is improving the health and wealth of the nation through research (

NSF: National Service Framework.

NSHPC: National Study of HIV in Pregnancy and Childhood. This is a confidential national (UK and Ireland) reporting scheme for pregnancies in women who are HIV positive, babies born to women who are HIV positive and other children with HIV (

Onward transmission: When a virus/infection is passed on from one individual to another.

Opportunistic infection: An infection that will usually only occur in a person who has a compromised immune system. Their occurrence in the context of HIV infection usually indicates that the person needs to start ART. Many are AIDS-defining.

p24 antigen: This is a component of the HIV virus that is one of the earliest markers of HIV. Testing for p24 antigen is used to detect primary HIV infection.

Post-exposure prophylaxis (PEP): Immediate HIV therapy (started within 72 hours of exposure), usually given for 4 weeks, following a high-risk HIV exposure. The aim is to reduce the risk of acquiring HIV.

PHE: Public Health England (

PN: Partner notification. This is a process whereby the sexual partners of people with a diagnosis of an STI are informed of their exposure to the infection.

Pre-exposure prophylaxis (PrEP): Anti-HIV medication taken by people who are HIV negative to lower their risk of acquiring HIV. It usually involves taking drugs on a daily basis.

Prophylaxis: Treatment that is given to prevent the occurrence of an infection.

QIPP: NHS Quality, Innovation, Productivity and Prevention.

RHIVA: Rehabilitation in HIV Association (

Stepped-care model: A model with four essential levels of psychological support provision for people living with HIV, based on levels of need.

STI: Sexually transmitted infection.

Treatment as prevention (TasP): An HIV prevention intervention where treating an HIV-positive person with antiretroviral medication is used to reduce the risk of transmission of the virus to a negative partner.

Tertiary care: Specialised consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a centre that has personnel and facilities for special investigation and treatment.

Transition: The purposeful, planned movement of adolescents and young adults with chronic physical and mental conditions from child-centred to adult-oriented health care systems.

TB: Tuberculosis. An infection due to Mycobacterium tuberculosis that is associated with HIV.

Tropism: HIV tropism refers to the cell type that the human immunodeficiency virus (HIV) infects and in which it replicates.

UNAIDS: The Joint United Nations Programme on HIV/AIDS (

Viral load: The quantity and activity of HIV in an individual’s blood, usually measured by a test that determines the number of copies/mL.

Viral rebound: Confirmed measurable HIV viral load, usually of more than 200 copies/mL, after previously reaching viral suppression on therapy.

Vertical transmission: Also known as ‘mother-to-child’ transmission. The transmission of an infection or other disease from a woman to her child. ‘Vertical transmission’ is a more inclusive term, and acknowledges the role of the father/male sexual partner.

Virtual clinic: Provision of expert advice by a multidisciplinary panel of experts from a specialist treatment centre on the therapeutic treatment options for a patient managed by a clinician located at the same or a different treatment centre via on-line and other ICT-based remote management systems.