Which aspects of health care are most valued by people living with HIV in high-income countries? A systematic review

Abstract

BackgroundIncreasing numbers of people with HIV are living into older age and experiencing comorbidities. The development of new models of care to meet the needs of this population is now a priority. It is important that the views and preferences of patients inform the development of services in order to maintain high levels of patient satisfaction and engagement. The aim of this systematic review was to determine which aspects of healthcare are particularly valued by people living with HIV.MethodsWe searched electronic databases and reference lists of relevant articles. The search strategy was developed to identify articles reporting on HIV positive patients’ perceptions, evaluations or experiences of healthcare services and factors associated with satisfaction with care. Peer-reviewed papers and conference abstracts were included if the study reported on aspects of health care that were valued by people living with HIV, data were collected during the era of combination therapy (from 1996 onwards), and the paper was published in English. A thematic approach to data synthesis was used.ResultsTwenty-three studies met the inclusion criteria. Studies used both qualitative and quantitative methods. Six studies specifically reported on relative importance to patients of different aspects of care. The valued aspects of care identified were grouped into seven themes. These highlighted the importance to patients of: a good health care professional-patient relationship, HIV specialist knowledge, continuity of care, ease of access to services, access to high quality information and support, effective co-ordination between HIV specialists and other healthcare professionals, and involvement in decisions about treatment and care. We were unable to determine the relative importance to patients of different aspects of care because of methodological differences between the studies.ConclusionsThis review identified several attributes of healthcare that are valued by people living with HIV, many of which would be relevant to any future reconfiguration of services to meet the needs of an ageing population. Further research is required to determine the relative importance to patients of different aspects of care.

Experience of primary care for people with HIV: a mixed-method analysis

“…6,17 Without other LTCs, PLHIV may have little or no contact with a GP, sometimes causing apprehension. The present findings are consistent with a systematic review of aspects of health care most valued by PLHIV in high-income countries, 18 which could be summarised to three main areas: a good, supportive practitioner-patient relationship involving patients in care decisions; access to specialist high quality HIV knowledge and support; and well-functioning care structures that provide effective, accessible continuity of care and services for all.…”

A discrete choice experiment to assess people living with HIV's (PLWHIV's) preferences for GP or HIV clinic appointments

“…The attributes and levels were derived from a systematic literature review 13 and a qualitative study. The latter included people who were at least 16 years age and registered for care with an National Health Service (NHS) HIV clinic.…”

“…The attributes and levels were derived from a systematic literature review 13 and a qualitative study.…”

Patients’ perspectives on the development of HIV services to accommodate ageing with HIV: a qualitative study

“…However, the review revealed a limited amount of research into patients' preferences for delivery of healthcare. 16 Recent fieldwork reported by the King's Fund has highlighted that although in general there is strong commitment to involving people in HIV services locally, almost all of the examples given were about how individual services operated, rather than how the various services combined to shape people's overall experience of living with HIV. 17 Therefore, aims of this study were to explore PLWHIV preferences for healthcare services outside of their HIV specialist services and to determine which aspects of care are valued.…”