`I’m not confident that my GP knows enough about treating people with HIV'

The bottom line: your HIV clinic could help by working with your GP, or by suggesting a different one.

Because of financial constraints in the NHS, there’s more and more pressure on people with HIV to use GP services (general practitioners or family doctors). Your HIV clinic may say that they can’t prescribe non-HIV drugs themselves, and that you need to see a GP instead.

There are lots of GPs who have enough knowledge and sensitivity to provide care for people with HIV. But you may be faced with a GP who thinks that HIV is too complicated to deal with, or who doesn’t know which medicines may interact with HIV drugs.

Get your HIV clinic involved

With your permission, they can:

• keep the GP informed about your test results
• tell the GP about any drug interactions to be aware of
• specifically ask the GP to prescribe something you need
• educate the GP on dealing with patients with HIV.

Remember that because of rules of confidentiality, the HIV clinic needs your permission before it can discuss your health with the GP. It may be the doctor, or perhaps a nurse specialist, who keeps contact with your GP.

You can ask the clinic to give you copies of any letters they send to the GP. This can sometimes help smooth out communication problems and confusions.

Changing your GP

But if you’ve had a bad experience with this GP, you may want to change to another one. Again, the clinic may be able to help - it may know GPs who have a good reputation. The clinic may already be in regular contact with GPs who are interested and experienced in treating people with HIV. Other people with HIV may also recommend GPs who are knowledgeable, non-judgemental and respect confidentiality.

Why you need a GP

As more people are living healthy lives with HIV, we need doctors with experience of treating the whole range of day to day health problems. GPs have a lot of experience with people who have long-term conditions like diabetes, kidney failure, asthma, and chronic depression.

Also HIV clinics no longer have the budgets to take care of all our health needs. Many clinics have had to stop issuing prescriptions for anti-depressants, blood pressure drugs, flu vaccines, and so on.

But GPs will not get involved in HIV treatment decisions, which are left to the HIV clinic. Your GP should liaise with your specialists when necessary.

Do you have to tell a GP that you have HIV?

There are good medical reasons to tell your GP that you have HIV. When treating you and making prescriptions, your doctor needs to know about other health issues you have, and other medicines you are taking.

But you aren’t legally obliged to say you have HIV – the choice is yours.

Registering with a new GP

Under NHS rules, you have to be registered with a GP to use their services. You can only register with a GP who is in your local area. If you don’t have a fixed address, you can use a ‘care of’ address of a friend or a support organisation.

Sometimes GPs cannot accept any more patients as they have too many already. To get a list of local GPs who can take new patients, contact the Patient Advice and Liaison Service (PALS) of the local Primary Care Trust. If you’re not sure how to get hold of PALS, ask NHS Direct (0845 4647).

Shop around

If you have a choice of GPs, shop around to make sure you get a decent service:

• Ask people you know for recommendations
• Phone the surgery anonymously and ask if they have experience of patients with HIV, or are ready to take new ones on
• Sexual health or HIV leaflets and posters in reception might be a clue to a GP who’s open to these issues
• Ask the Primary Care Trust if any local GPs offer an “enhanced sexual health service” – these doctors are usually more knowledgeable about HIV
• If you over-hear confidential information about someone in the waiting area, this GP is best avoided
• Check the opening hours, waiting times for an appointment, arrangements for emergency cover, and how easy it will be for you to get there
• If you do mention HIV, how does the GP react?

If you’re unable to find a GP who is HIV-friendly, go back and tell your clinic. They may need to work with the Primary Care Trust to make sure that safe and appropriate services are available. It’s the Primary Care Trust’s responsibility to ensure that all local residents can see a GP.