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HIV clinics
HIV care is provided through outpatient clinics. This means that you do not receive your treatment whilst staying in hospital, but visit a specialist doctor at regular intervals who will monitor your health, prescribe treatments and, if you need to, refer you to see other specialists.
Many HIV clinics are attached to a GUM clinic, and there’s a good chance that you will be receiving your HIV care from the HIV clinic associated with the GUM clinic where you were diagnosed with HIV.
Unlike any other specialism within the NHS, GUM and HIV clinics operate an open access policy. You don’t need your family doctor to refer you. All you have to do is phone up and make an appointment. You can choose which HIV treatment centre you receive your care from. You do not have to attend the clinic at the hospital you were diagnosed at. If you wish, you can use the HIV treatment centre in a different city. If you decide to change clinics, it’s very important to ensure that your medical notes are forwarded from your old clinic to your new one.
If you are entitled to free NHS care, then all the treatment you receive from your HIV clinic will be free. Even if you normally have to pay for prescriptions, nearly all medicines prescribed by a specialist HIV doctor will be free.
It’s likely that as well as regular appointments with a doctor who specialises in the treatment of HIV, your clinic will have other specialist services available to you. There will almost certainly be a specialist HIV pharmacist. There’s also a good chance that there might be nurse-led clinics looking after sexual health, or supporting adherence to drug regimens. The very large HIV clinics may also have specialist HIV mental health teams, and access to dentists.
An emergency walk-in doctor service is provided by some clinics during normal working hours. This is intended for problems requiring urgent medical attention.
Opening times vary between clinics. You can expect the very large clinics to be open and to offer appointments with doctors and other health professionals every working day. By contrast, smaller clinics might only be open a few mornings or afternoons a week.
All clinics will have arrangements for providing emergency care. The large HIV clinics will have an HIV doctor who is on call 24 hours a day for an emergency, while at smaller hospitals emergency cover might be provided by a general medicine doctor.
The factors influencing choice of clinic differ from person to person. Some might prefer to attend a clinic that is large, with a reputation for expertise. Others opt to attend smaller clinics that are more accessible and convenient.
Whichever clinic you attend, it’s very important that you receive appropriate treatment and care that you are comfortable with. If you are not satisfied with the level of service you are receiving, then complain to the clinic management. Set out clearly what you are unhappy about. An advocacy organisation such as the UK Coalition of People Living with HIV and AIDS might be able to help. Try not to get angry, and don’t get abusive. The chances are that your complaint will be settled satisfactorily. If your complaint isn’t settled to your satisfaction, then remember you can change to a different clinic.
Your HIV clinic will also have facilities to treat inpatients (treatment whilst staying in hospital). Large clinics are likely to have a dedicated HIV ward with doctors and nurses who only treat HIV-positive patients. If you attend a smaller clinic, then inpatient care is likely to be provided on a general medical or infectious diseases ward.
Staff on specialist inpatient wards may well have more insight into the medical and psychological issues faced by people with HIV, and will have more skill at recognising and treating both the common and uncommon illnesses and complications seen in people with HIV. Other staff at hospitals with a large HIV clinic, such as pharmacists, dieticians, radiologists and physiotherapists will also have extensive experience of treating HIV-positive patients.
It’s worth bearing in mind that the large HIV clinics, which have lots of patients and more expertise, have better survival and outcome rates for their patients. To put it simply: if you go to a large clinic with experienced staff, you improve your chances of living a longer, healthier life.
If you are admitted to hospital for a reason unconnected to HIV, it’s very important to let the doctors and nurses looking after you know that you are HIV-positive, to ensure that you receive the right treatment.