Improvements in the treatments offered to people with HIV mean that it is now manageable as a chronic condition. HIV is mostly managed in secondary care but there are some aspects that GPs need to be aware of, which Dr Toni Hazell discusses in this week’s featured article.
Early diagnosis of HIV vastly improves prognosis, so it is important that GPs in high-prevalence areas take opportunities to offer HIV testing. Tests should be offered to all new patients at registration, to people having blood tests for another reason, and to those who have symptoms consistent with HIV infection.
Dr Hazell also highlights the issues surrounding contraception and fertility. HIV is generally not a contraindication to contraception; however, drug interactions reduce the number of available options in women on enzyme-inducing antiretroviral therapy. Discordant couples who are trying to conceive should be informed about conception strategies that reduce the risk of HIV transmission.
Confidentiality and legal issues are also highlighted because GPs may need to breach confidentiality if they become aware that a patient with HIV has not informed their partner of their HIV-positive status.
Use the multiple-choice questions to test your updated knowledge after reading the article.