Article Figures & Data
Tables
- Table 1. Factors associated with GP disclosure and recent attendance among PLHIV registered with a GP
Denominator Disclosed to GP Attended GP inthe last3months Weighted Unweighted % OR (95% CI) P value % OR (95% CI) P value Overall 83 668 4422 93.8 58.0 Gender and sexuality a 0.01 0.001 Gay and bisexual men 38 300 2264 92.8 1 55.6 1 Heterosexual men 19 217 846 93.3 1.08 (0.75 to 1.56) 56.3 1.03 (0.87 to 1.23) All women 26 150 1208 95.6 1.68 (1.18 to 2.38) 62.0 1.31 (1.14 to 1.50) Age, years <0.001 0.003 15–34 10 535 490 88.8 1 51.5 1 35–49 36 413 1911 93.5 1.81 (1.28 to 2.57) 56.3 1.21 (0.95 to 1.53) ≥50 36 720 1915 95.5 2.63 (1.97 to 3.51) 61.3 1.48 (1.15 to 1.91) Residence 0.064 0.002 London 41 364 2146 92.1 1 58.6 1 South of England 12 186 693 94.4 1.44 (0.88 to 2.38) 52.3 0.76 (0.61 to 0.94) Midlands, East of England, and Wales 16 883 885 95.2 1.70 (1.05 to 2.75) 57.9 0.95 (0.76 to 1.19) North of England 13 235 698 95.9 2.02 (1.01 to 4.05) 62.0 1.14 (0.97 to 1.34) Education level <0.001 <0.001 Primary or less 5562 267 98.6 1 64.9 1 Upper secondary 32 403 1603 94.5 0.23 (0.09 to 0.62) 59.1 0.79 (0.61 to 1.03) Technical & vocational 8244 410 95.7 0.31 (0.11 to 0.83) 64.8 1.00 (0.69 to 1.45) Bachelor’s degree 24 268 1167 92.8 0.18 (0.07 to 0.44) 54.6 0.65 (0.47 to 0.90) Postgraduate degree 13 191 662 91.4 0.14 (0.06 to 0.35) 53.5 0.62 (0.47 to 0.82) Employment status <0.001 <0.001 Employed 54 240 2736 92.2 1 51.0 1 Unemployed 9108 421 95.6 1.84 (1.03 to 3.28) 66.5 1.90 (1.52 to 2.38) Economically inactiveb 20 320 1055 97.4 3.16 (1.84 to 5.43) 71.9 2.46 (2.02 to 3.0) Non-HIV comorbidities <0.001 <0.001 None 25 073 1272 89.8 1 42.7 1 One 19 573 997 92.0 1.29 (0.80 to 2.07) 51.6 1.46 (1.20 to 1.76) Two 13 547 724 95.2 2.27 (1.45 to 3.56) 61.2 1.98 (1.64 to 2.40) Three 9795 530 97.0 3.69 (2.01 to 6.78) 70.9 3.19 (2.59 to 3.92) Four or more 15 679 866 98.3 6.39 (2.93 to 13.95) 79.1 4.92 (3.92 to 6.18) Self-rated health 0.012 <0.001 Good/very good 60 737 3161 92.9 1 52.4 1 Fair 18 037 943 95.7 1.68 (1.03 to 2.73) 68.6 1.99 (1.65 to 2.39) Bad/very bad 4894 255 98.8 6.22 (1.27 to 30.53) 84.9 5.16 (3.47 to 7.69) Money for basic needs 0.004 <0.001 Yes, always 39 142 2019 92.6 1 50.6 1 Not always 44 526 2075 94.9 1.48 (1.114 to 1.93) 64.2 1.73 (1.51 to 1.98) ART status 0.004 0.072 On ART 81 778 4294 94.0 1 58.3 1 Not on ART 1890 99 86.7 0.42 (0.23 to 0.75) 47.9 0.66 (0.41 to 1.04) Viral suppression c 0.987 0.053 Yes 81 333 3539 93.9 1 57.4 1 No 2335 98 93.9 0.99 (0.39 to 2.56) 67.7 1.53 (0.99 to 2.35) Year of HIV diagnosis <0.001 <0.001 Pre-1996 10 298 545 97.6 1 66.1 1 1996–2005 31 871 1593 94.8 0.45 (0.26 to 0.77) 59.3 0.75 (0.60 to 0.94) 2006–2017 41 499 2149 92.1 0.29 (0.16 to 0.53) 54.8 0.62 (0.49 to 0.78) Worried about discrimination in health care due to HIV 0.833 0.005 Never 54 169 2733 94.1 1 56.8 1 >1 year ago 16 210 840 94.3 1.01 (0.69 to 1.49) 56.2 0.97 (0.83 to 1.13) In the last year 13 289 670 93.5 0.89 (0.59 to 1.36) 64.3 1.36 (1.13 to 1.63) Avoided health care due to HIV <0.001 0.159 Never 68 465 3442 94.8 1 57.7 1 >1 year ago 7035 345 90.6 0.52 (0.34 to 0.79) 54.1 0.85 (0.68 to 1.06) In the last year 8168 400 89.1 0.44 (0.28 to 0.70) 60.3 1.11 (0.92 to 1.33) ART = antiretroviral therapy. CI = confidence intervals. OR = odds ratio.
a Transmen and transwomen are included in the gender groups with which they self-identified. Due to small numbers, those who identify as non-binary/in another way (representing 0.5% of Positive Voices responders) are excluded from the binary gender breakdown. Gay and bisexual men are identified as MSM (men who have sex with men) in the main text.
b Economically inactive includes individuals who are not in employment or unemployed, including those who are retired, looking after family, long-term sick, carers, students, and those whose immigration status does not permit them to do paid work.
c Viral suppression defined as VL <200 copies/ml in last reported viral load result in 2017.
- Table 2. Factors associated with patient-reported experience measuresa among PLHIV registered with their GP
GP knowsenough about HIV GP is as involved as I want them to be in HIV care Good communicationbetween GP and HIV specialist Comfortableasking GP questions about HIV %agreement OR(95%CI) P value %agreement OR(95% CI) P value %agreement OR(95% CI) P value %agreement OR(95% CI) Pvalue Overall 64.7 65.1 64.1 58.9 Gender and sexuality b <0.001 <0.001 <0.001 0.018 Gay and bisexual men 57.6 1 69.2 1 57.3 1 57.6 1 Heterosexual men 73.1 1.98 (1.65 to 2.37) 67.4 0.94 (0.78 to 1.13) 69.8 1.72 (1.41 to 2.10) 65.4 1.39 (1.11 to 1.74) All women 69.0 1.63 (1.36 to1.96) 58.5 0.63 (0.52 to 0.74) 70.0 1.73 (1.41 to 2.11) 56.2 0.93 (0.82 to 1.08) Age , years <0.001 <0.001 <0.001 <0.001 15–34 56.3 1 57.6 1 52.3 1 48.3 1 35–49 62.5 1.27 (1.02 to 1.60) 61.3 1.15 (0.93 to 1.43) 61.5 1.44 (1.12 to 1.86) 55.2 1.31 (1.01 to 1.69) ≥50 69.3 1.74 (1.36 to 2.22) 72.0 1.86 (1.43 to 2.43) 70.0 2.10 (1.62 to 2.74) 65.9 2.05 (1.57 to 2.67) Residence 0.279 0.039 <0.001 0.058 London 65.0 1 62.3 1 59.1 1 57.3 1 South of England 61.9 0.88 (0.74 to 1.05) 68.3 1.29 (1.03 to 1.61) 63.0 1.18 (0.93 to 1.51) 59.7 1.03 (0.79 to 1.33) Midlands, East of England, and Wales 64.4 0.99 (0.81 to 1.20) 64.9 1.11 (0.87 to 1.41) 69.0 1.55 (1.26 to 1.90) 58.9 1.01 (0.84 to 1.22) North of England 66.9 1.10 (0.90 to 1.20) 69.9 1.38 (1.05 to 1.81) 71.4 1.72 (1.44 to 1.51) 63.6 1.31 (1.06 to 1.61) Education level 0.033 0.158 <0.001 <0.001 Primary or less 71.2 1 69.3 1 71.1 1 66.7 1 Upper secondary 66.3 0.80 (0.60 to 1.07) 66.7 0.87 (0.66 to 1.14) 65.9 0.81 (0.55 to 1.20) 62.1 0.84 (0.62 to 1.14) Technical & vocational 66.6 0.80 (0.58 to 1.10) 67.6 0.89 (0.60 to 1.32) 68.1 0.89 (0.56 to 1.40) 64.0 0.90 (0.65 to 1.24) Bachelor’s degree 63.0 0.69 (0.51 to 0.93) 64.8 0.80 (0.61 to 1.04) 63.3 0.73 (0.50 to 1.06) 55.5 0.64 (0.47 to 0.86) Postgraduate degree 58.0 0.55 (0.37 to 0.82) 62.7 0.72 (0.51 to 1.02) 54.7 0.51 (0.34 to 0.76) 51.5 0.54 (0.37 to 0.78) Employment status 0.011 <0.001 <0.001 <0.001 Employed 62.2 1 63.9 1 60.7 1 56.8 1 Unemployed 68.2 1.32 (0.97 to 1.78) 60.5 0.86 (0.66 to 1.12) 64.4 1.15 (0.91 to 1.45) 60.4 1.16 (0.95 to 1.41) Economically inactivec 67.5 1.26 (1.09 to 1.47) 71.2 1.37 (1.13 to 1.65) 70.5 1.53 (1.28 to 1.82) 63.4 1.30 (1.14 to 1.48) Non-HIV comorbidities <0.001 0.328 0.358 0.281 None 67.4 1 62.4 1 62.8 1 60.2 1 One 61.6 0.84 (0.72 to 0.99) 65.0 1.10 (0.87 to 1.40) 62.5 1.07 (0.85 to 1.33) 58.5 0.98 (0.84 to 1.14) Two 66.1 0.93 (0.76 to 1.15) 67.3 1.23 (0.93 to 1.62) 64.2 1.10 (0.89 to 1.35) 61.0 0.98 (0.79 to 1.23) Three 67.9 1.09 (0.82 to 1.45) 69.4 1.34 (1.00 to 1.80) 67.0 1.23 (0.93 to 1.63) 58.4 0.99 (0.79 to 1.24) Four or more 60.0 0.77 (0.63 to 0.94) 66.0 1.17 (0.87 to 1.57) 65.8 1.20 (098 to 1.46) 56.4 0.87 (0.73 to 1.03) Self-rated health <0.001 0.007 0.351 0.023 Good/very good 66.9 1 66.2 1 64.7 1 60.7 1 Fair 60.3 0.75 (0.63 to 0.90) 64.2 0.91 (0.73 to 1.14) 63.5 0.94 (0.80 to 1.11) 55.5 0.81 (0.68 to 0.96) Bad/very bad 55.2 0.61 (0.45 to 0.83) 57.8 0.70 (0.56 to 0.87) 60.2 0.83 (0.64 to 1.07) 54.0 0.76 (0.59 to 0.97) Money for basic needs 0.004 <0.001 0.018 0.271 Yes, always 62.3 1 70.1 1 61.3 1 60.1 1 Not always 66.5 1.20 (1.06 to 1.36) 61.3 0.66 (0.55 to 0.80) 66.3 1.23 (1.04 to 1.46) 58.0 0.92 (0.80 to 1.07) ART status 0.737 0.611 0.936 0.259 On ART 64.7 1 65.1 1 64.0 1 58.8 1 Not on ART 63.2 0.92 (0.55 to 1.52) 68.5 1.16 (0.64 to 2.11) 63.9 0.98 (0.58 to 1.65) 66.1 1.35 (0.80 to 2.29) Viral suppression d 0.517 0.039 0.209 0.566 Yes 63.7 1 65.1 1 63.7 1 58.5 1 No 66.9 1.17 (0.72 to 1.92) 51.7 0.58 (0.34 to 0.97) 55.9 0.72 (0.43 to 1.20) 54.7 0.86 (0.52 to 1.44) Year of HIV diagnosis 0.013 0.038 0.053 0.191 Pre-1996 59.2 1 69.0 1 64.1 1 58.3 1 1996–2005 65.6 1.29 (1.07 to 1.55) 62.7 0.74 (0.59 to 0.94) 66.1 1.09 (0.94 to 1.26) 57.1 0.95 (0.75 to 1.20) 2006–2017 64.6 1.26 (1.07 to 1.49) 65.7 0.86 (0.69 to 1.08) 61.4 0.90 (0.77 to 1.05) 59.9 1.08 (0.87 to 1.34) Worried about discrimination in health care due to HIV <0.001 <0.001 <0.001 <0.001 Never 70.5 1 69.4 1 67.6 1 65.8 1 >1 year ago 55.7 0.52 (0.42 to 0.64) 61.1 0.68 (0.57 to 0.81) 59.7 0.70 (0.60 to 0.83) 50.4 0.52 (0.44 to 0.62) In the last year 49.8 0.42 (0.34 to 0.51) 54.3 0.52 (0.40 to 0.69) 53.9 0.56 (0.45 to 0.70) 41.4 0.37 (0.30 to 0.45) Avoided seeking health care when needed due to HIV <0.001 <0.001 <0.001 <0.001 Never 67.6 1 68.3 1 65.7 1 62.3 1 >1 year ago 53.0 0.55 (0.42 to 0.73) 59.3 0.67 (0.51 to 0.90) 56.6 0.67 (0.51 to 0.89) 46.7 0.53 (0.42 to 0.66) In the last year 43.6 0.37 (0.31 to 0.45) 46.5 0.40 (0.33 to 0.50) 52.7 0.58 (0.44 to 0.77) 36.3 0.35 (0.28 to 0.43) ART = antiretroviral therapy. CI = confidence intervals. OR = odds ratio. PLHIV = people living with HIV.
aThe four 5-item Likert scale patient-reported experience measures (PREMS) on experience with their GP as relates to their HIV: 1)'My GP knows enough about my HIV condition and treatment'; 2) 'My GP is as involved as I want them to be with my HIV care'; 3) 'My HIV specialist and my GP communicate well regarding my health'; 4)'I am comfortable asking my GP questions about HIV'. Responses of ‘Strongly Agree‘ and ‘Agree‘ were combined, and ‘Disagree‘, ‘Strongly Disagree‘, and ‘Don’t know or Not applicable‘ were combined.
bTransmen and transwomen are included in the gender groups with which they self-identified. Due to small numbers, those who identify as non-binary/in another way (representing 0.5% of Positive Voices respondents) are excluded from the binary gender breakdown. Gay and bisexual men are identified as MSM (men who have sex with men) in the main text.
cEconomically inactive includes individuals who are not in employment or unemployed, including those who are retired, looking after family, long-term sick, carers, students, and those whose immigration status does not permit them to do paid work.
dViral suppression defined as VL <200 copies/ml in last reported viral load result in 2017.