Barts Health NHS Trust, Royal London Hospital, London, UK.
British HIV Association, London, UK.
HIV Med. 2019 Jul;20(6):424-427. doi: 10.1111/hiv.12744. Epub 2019 Apr 22.
The aim of this national audit was to assess adherence of services providing HIV care in the UK to national standards and guidelines regarding psychological support and the assessment of alcohol and recreational drug use (including chemsex drugs) in people living with HIV (PLWH).
Participating sites completed a survey of their services' care pathways relating to psychological support and substance use. They performed a case-note review of up to 40 adult PLWH per service, reviewing sociodemographic and clinical information and assessment of psychological wellbeing, drug use and alcohol use. The surveys and case notes were assessed against relevant British HIV Association (BHIVA) guidelines and standards.
The survey was completed by 112 services. Of these, 73%, 82% and 73% had formal annual processes for assessing the psychological wellbeing, alcohol use and drug use, respectively, of PLWH. Case-note data were provided for 4486 PLWH from 119 sites. Audited rates of assessment of PLWH were 66.0% for psychological wellbeing, 68.0% for alcohol use, 58.4% for recreational drug use and 16.8% for chemsex drug use. Variation between clinical services was wide, with ranges from < 10% to 100% routinely assessing PLWH for each of these domains. Services using assessment tools performed better.
Assessment of PLWH for psychological wellbeing and alcohol and recreational drug use is variable in UK clinics, with a significant minority of services not documenting that they assessed these factors routinely. Wider adoption of assessment tools or proformas to assess PLWH in these areas is likely to improve surveillance for psychological morbidity and problematic alcohol or drug use.
本全国性审计旨在评估英国提供艾滋病毒护理服务的机构对关于艾滋病毒感染者（PLWH）心理支持以及酒精和娱乐性药物使用（包括 Chemsex 药物）评估的国家标准和指南的遵循情况。
参与的机构完成了一项关于其服务与心理支持和物质使用相关的护理路径的调查。他们对每个服务机构的多达 40 名成年 PLWH 进行了病历回顾，审查社会人口统计学和临床信息以及心理幸福感、药物使用和酒精使用的评估。这些调查和病历记录根据相关的英国艾滋病毒协会（BHIVA）指南和标准进行评估。
有 112 个服务机构完成了调查。其中，73%、82%和 73%的机构分别有正式的年度程序来评估 PLWH 的心理幸福感、酒精使用和药物使用情况。从 119 个服务机构提供了 4486 名 PLWH 的病历数据。审核的 PLWH 评估率为心理幸福感 66.0%，酒精使用 68.0%，娱乐性药物使用 58.4%，Chemsex 药物使用 16.8%。临床服务之间的差异很大，范围从<10%到 100%，每个服务机构都常规评估这些领域的 PLWH。使用评估工具的服务表现更好。
英国诊所中对 PLWH 的心理幸福感以及酒精和娱乐性药物使用的评估存在差异，少数服务机构未记录常规评估这些因素。更广泛地采用评估工具或表格来评估这些领域的 PLWH，可能会改善对心理发病率和问题性酒精或药物使用的监测。
