Increasing attention has been given to the emerging and anticipated care needs of the ageing HIV population. To investigate the local experience of people living with HIV in Lothian, the NHS Lothian HIV Care & Treatment Group of the Sexual Health and Blood Borne Virus Programme Board requested that a health needs assessment be undertaken. 

Download the NHS Lothian's Health Needs Assessment: Ageing with HIV report

Purpose

This needs assessment focused on people living with HIV over the age of 50 in Lothian and aimed to:

  1. Assess the health and social care needs of PLWH attending HIV services in NHS Lothian;
  2. Assess the extent to which current services are meeting existing and anticipated demand;
  3. Make recommendations for the planning and delivery of HIV services;
  4. Make recommendations for staff training, and;
  5. Identify opportunities to address HIV stigma.

Key Findings

  • 47% of people living with HIV in Lothian are over 50 years old (695); and 25% are 61 or older;
  • RIDU has a higher proportion of service users attending who are over 50. RIDU also has a higher proportion of service users who are female, acquired HIV via heterosexual and injecting drug use routes, co-infected with hepatitis C, and of African ethnicity, compared with service users attending Chalmers;
  • 86% of service users over 50 years old are of White (Scottish, Irish, other British) ethnic origin; the majority were diagnosed prior to 2005 and 34% were diagnosed prior to the introduction of HAART in 1996;
  • 42% of the cohort had had an inpatient admission and 45% had had at least one A&E attendance over the last five years. Patients diagnosed prior to 1997 were more likely to have an inpatient admission or A&E attendance compared to those diagnosed after;
  • Current recording of data on NHS databases does not support the management of people with co/multi-morbidities;
  • There was support for discussion between secondary, primary and community care regarding future models of care to support people with HIV who have other conditions, and;
  • Stigma and lack of basic knowledge about HIV is still a concerning issue.

Recommendations

A series of recommendations were made in conjunction with the HIV Care & Treatment Group and have been organised under the following headings:

  • Clinical Assessment & Provision
  • Service Configuration
  • Training
  • Care Homes
  • Supporting Patients

The involvement of people living with HIV is essential to the successful implementation of many, if not all, of the actions under the headings above. The needs assessment also identified several challenges with current patient databases and systems. The group agreed to deal with these concerns separately from this report.