title: Learning from the experiences of people with HIV using general practitioner services in London: a qualitative study.
abstract: Aim To explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use.
  
  
  
  Traditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care.
  
  
  
  This paper presents qualitative findings from a mixed method study of PWHIV's experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services. Findings Three factors emerged which mediated experiences of GP care. Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions. Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use. Communication: lack of communication between GPs and HIV specialists led to what participants called 'patient ping-pong' where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care.
  
  
  
  Meaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management.
authors.affiliation: 1Senior Lecturer in Public Health, Faculty of Health and Social Care,The Open University,Milton Keynes,UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Keogh
authors.affiliation: 2Senior Lecturer in Sexual Health and HIV,School of Environmental Health Research,London School of Hygiene & Tropical Medicine,London,UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Weatherburn
authors.affiliation: 3Research Fellow,School of Environmental Health Research,London School of Hygiene & Tropical Medicine,London,UK.
authors.forename: David
authors.initials: D
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D058006:General Practice / Q000379:methods*; D015658:HIV Infections / Q000628:therapy*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D055815:Young Adult
keywords: HIV; general practice; qualitative research; service acceptability; service use