Jones Howell T, Lynch Lucy, Barber Tristan J, Rattue Meriel, Waters Laura J, Asboe David, Walker Angeline, Williams Ian
Ian Charleson Day Centre, Royal Free London NHS Foundation Trust, London, UK.
Institute for Global Health, UCL, London, UK.
HIV Med. 2025 Jul;26(7):1004-1033. doi: 10.1111/hiv.70041. Epub 2025 May 7.
The average age of a person living with HIV in high-income countries is increasing, as are rates of multimorbidity and frailty. To meet these needs, existing services must adapt. This review aimed to identify the existing literature on what services are available to undertake long-term condition management (LTCM) for People with HIV in England.
A scoping review employing the Arksey & O'Malley's methodological framework was performed. Seven databases were searched most recently in October 2024 for studies describing services, interventions, or support for People with HIV in England to manage their overall health and wellbeing. Study inclusion was not limited by year of publication. Narrative reviews were excluded. Two reviewers independently performed data extraction using predetermined criteria, followed by a descriptive analysis.
Forty publications were identified with six key areas where LTCM was addressed: HIV services, secondary care services, primary care, palliative care, peer support, self-management, and specialist services, suggesting that currently no service can undertake LTCM alone.
If LTCM for People with HIV is to expand outside of HIV services, then additional HIV training is required for healthcare professionals with a focus on reducing stigma. Peer support should be at the forefront, and People with HIV should be involved in the assessment of need, design, and evaluation of services. There is a scarcity of high-level evidence, which justifies the need for further research and ongoing service evaluation to identify the optimal model(s) to ensure effective, equitable, and cost-effective care.
高收入国家中感染艾滋病毒者的平均年龄在增加，多重疾病和身体虚弱的发生率也在上升。为满足这些需求，现有服务必须做出调整。本综述旨在确定关于英格兰为艾滋病毒感染者提供哪些长期疾病管理（LTCM）服务的现有文献。
采用阿克斯西和奥马利的方法框架进行了一项范围综述。2024年10月最近一次检索了七个数据库，以查找描述为英格兰艾滋病毒感染者管理其整体健康和福祉的服务、干预措施或支持的研究。研究纳入不受出版年份限制。排除叙述性综述。两名评审员使用预先确定的标准独立进行数据提取，随后进行描述性分析。
确定了40篇出版物，涉及长期疾病管理的六个关键领域：艾滋病毒服务、二级医疗服务、初级医疗、姑息治疗、同伴支持、自我管理和专科服务，这表明目前没有一项服务能够单独承担长期疾病管理。
如果要在艾滋病毒服务之外扩大对艾滋病毒感染者的长期疾病管理，那么医疗保健专业人员需要接受额外的艾滋病毒培训，重点是减少耻辱感。同伴支持应处于前沿，艾滋病毒感染者应参与需求评估、服务设计和评估。高水平证据匮乏，这证明有必要进行进一步研究和持续的服务评估，以确定确保有效、公平和具有成本效益的护理的最佳模式。
