Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London, UK.
Sex Transm Infect. 2009 Dec;85(7):543-9. doi: 10.1136/sti.2009.035865. Epub 2009 Oct 22.
To investigate the role of primary care in the management of HIV and estimate primary care-associated costs at a time of rising prevalence.
Retrospective cohort study between 1995 and 2005, using data from general practices contributing data to the UK General Practice Research Database. Patterns of consultation and morbidity and associated consultation costs were analysed among all practice-registered patients for whom HIV-positive status was recorded in the general practice record.
348 practices yielded 5504 person-years (py) of follow-up for known HIV-positive patients, who consult in general practice frequently (4.2 consultations/py by men, 5.2 consultations/py by women, in 2005) for a range of conditions. Consultation rates declined in the late 1990s from 5.0 and 7.3 consultations/py in 1995 in men and women, respectively, converging to rates similar to the wider population. Costs of consultation (general practitioner and nurse, combined) reflect these changes, at pound100.27 for male patients and pound117.08 for female patients in 2005. Approximately one in six medications prescribed in primary care for HIV-positive individuals has the potential for major interaction with antiretroviral medications.
HIV-positive individuals known in general practice now consult on a similar scale to the wider population. Further research should be undertaken to explore how primary care can best contribute to improving the health outcomes of this group with chronic illness. Their substantial use of primary care suggests there may be potential to develop effective integrated care pathways.
探讨初级保健在艾滋病毒管理中的作用，并在流行率上升的情况下估算初级保健相关成本。
使用来自向英国普通实践研究数据库提供数据的普通实践的数据，进行 1995 年至 2005 年的回顾性队列研究。分析所有在普通实践记录中记录为艾滋病毒阳性的实践登记患者中，咨询模式和发病率以及相关咨询成本。
348 家实践产生了 5504 人年（py）的已知艾滋病毒阳性患者随访记录，他们经常在普通实践中就诊（2005 年男性 4.2 次就诊/py，女性 5.2 次就诊/py），用于治疗一系列疾病。在 1990 年代后期，咨询率从男性和女性分别在 1995 年的 5.0 和 7.3 次就诊/py 下降，趋于与更广泛人群相似的水平。咨询成本（全科医生和护士，合计）反映了这些变化，2005 年男性患者为 100.27 英镑，女性患者为 117.08 英镑。在初级保健中为艾滋病毒阳性个体开的大约六分之一的药物可能与抗逆转录病毒药物发生重大相互作用。
现在在普通实践中已知的艾滋病毒阳性个体的咨询规模与更广泛的人群相似。应该进行进一步的研究，探讨初级保健如何能够最好地为改善这一慢性病群体的健康结果做出贡献。他们对初级保健的大量使用表明，有可能开发有效的综合护理途径。
