Dr. Naomi Sutton is joined by Dr. Grace Bottoni and Dr. Kate Childs for this episode to talk about a growing challenge in HIV: re-engaging people living with HIV who are out of care. Kate and Grace both play key roles in delivering the world’s first Social Impact Bond that focuses on bringing people living with HIV back into care. Kate explains the meaning of “not in care”, why it’s important and the size of the problem in the UK. Grace takes listeners through her personal experiences of re-engaging people back into care as a GP and highlights some barriers that some patients need to overcome. Kate, Grace and Naomi discuss why people may be out of care, while sharing compelling cases and strategies for re-engagement that have worked for their patients.

" If we want to end HIV by 2030, the people out of care are a really important group to address. And Primary Care teams are in one of the best positions to support these people. "

" People who are out of care often don't really want to be out of care. They found themselves in that situation. It's the same way I haven't been to the dentist for ages. It's something they know they should be doing, but they haven't quite got around to and they feel well. And they often feel quite guilty and ashamed about that as well. "

" There are three main questions that you can ask, and these are not to be asked in a judgmental way. And it's just you being inquisitive because as I said, HIV is a chronic condition and you would ask these questions of any person with a chronic condition like diabetes or COPD"

Resources:

Elton John AIDS Foundation, Achievements of the Zero HIV Social Impact Bond

University of Liverpool HIV Drug Interactions website

Howarth et al. REACH study

HIV Prevention England, Practical guidance for Primary Care to optimise HIV testing and re-engagement of people living with HIV

Dr. Grace Bottoni is an HIV GP Champion, as well as a Hepatitis C Champion, working out of the borough of Lewisham in South East London. Her clinical interests include increasing testing in primary care and re-engaging patients living with HIV who are out of care, while reducing stigma in healthcare settings. Dr. Bottoni is also the local clinical lead for the Clinical Effectiveness Group in South East London. Reach out to Grace on LinkedIn with your questions.

Dr Kate Childs is an HIV consultant at Kings College Hospital, London and her clinical interests include re-engaging people living with HIV who are out of care, improving access to care, and HIV-associated liver disease. Dr. Childs is on the British HIV Association (BHIVA) co-infection guidelines writing group and was elected to the BHIVA Executive Committee as a trustee in 2023.

UK-UNB-4889

Jan 2024

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