Your Guide To...BHIVA Standards of Care for People Living with HIV


4. Complex HIV care

If you are in the UK, and diagnosed relatively soon after you acquired HIV, then it is most likely that you will NOT need complex HIV care as described in this section. You are more likely to get everything you need for your HIV care as described in Standard 3 (HIV outpatient care and treatment). There may still some circumstances where more complex care will be needed. The three main areas of complex care need are described here in Standard 4. This, though, focuses on physical health. Emotional wellbeing and mental health are discussed in Standard 6 (Psychological Care).

Standard 4 - Complex HIV care


4c. Supporting people with higher levels of need

People living with HIV still experience high levels of stigma and discrimination, and they are more likely to face social disadvantage, for example, poverty or being homeless. This can badly affect a person’s quality of life.

People living with HIV are more likely to have multiple long-term conditions; poorer mental health; poorer sexual health; and higher levels of alcohol and substance misuse. They are more likely to face economic hardship, and intimate partner violence.

If you face problems such as these, it can be harder to manage your healthcare well. It may be that you struggle to get to clinic, or that you find it difficult to take your ARVsARV: Antiretroviral .This is the name given to the drugs used in Anti-Retroviral Treatment (ART). For many people, a single tablet can contain all ARVs needed for your treatment. But others may need to take more than one tablet. as you should. This could result in your health getting worse. So, when you are diagnosed with HIV, you should get a complete assessment of all your healthcare needs. Wider social issues such as housing, finances, employment and social support should also be considered, since these can have an impact on your health. You should feel safe and able to discuss any of these things with your healthcare team.

If you need increased support to deal with such issues, a personalised care planthis involves a whole-system approach, integrating services around the person by involving health, social care, public health and other issues. It is based on ‘what matters’ to the individual, and their individual strengths and needs. should be developed for you. This could involve your GP, or another care coordinator, such as a specialist HIV nurse. Support could include local HIV services and peer groups. You might need to be referred to other support services, such as for help with alcohol or drug dependency, or poor mental health. Peer support, which lets you share your experiences with other people living with HIV, can also be of great help, both practically and emotionally.

Your needs can change over time, so a complete needs assessment should be repeated by your HIV healthcare team every year.


Key messages

  • A thorough assessment of all your physical, mental and social needs should be made when you are diagnosed. This should be repeated annually. It should give you information about where to get the support you need.

  • If you need increased support, an individualised care planthis involves a whole-system approach, integrating services around the person by involving health, social care, public health and other issues. It is based on ‘what matters’ to the individual, and their individual strengths and needs. should be made for you.

  • If needed, you might be referred to a wide range of other support services, including peer support.

  • Services should have safe and confidential referral systems, especially to support people experiencing intimate partner violence.