Determinants of self-reported health and well-being outcomes among people living with HIV in the UK: a mixed-methods exploration of the impact of stru

The treatment and care of people living with Human
Immunodeficiency Virus (HIV) has significantly improved in
the past two decades across the United Kingdom (UK).
These advancements now mean that people can live with HIV
for much of their life, with few complications; it is a "chronic"
(or lifelong) condition and is considered 'beyond
undetectable'. Yet, differences in clinical stage at diagnosis
and how people manage their other health conditions (comorbidities) alongside HIV still exist. People living with HIV
have also described an unmet need in social and welfare
services being provided, which includes services such as
immigration or employment support, and whose funding has
been affected by recent changes in government policies.
This project looks to investigate why differences exist for the
health and wellbeing of people living with HIV, and how much
this can be explained by peoples' economic and social
circumstances (their social determinants). We will also
explore whether recent changes in public policies, including
those related to the reported "hostile environment" for
immigration, have also affected the experiences faced by
people living with HIV when accessing social and welfare
services in the UK.
We will use two main methods to explore these differences;
firstly, analysing data from a survey conducted in 2017 by
Public Health England (PHE) of over 4,000 adults living with
HIV in the UK, the Positive Voices study. Secondly, we will
conduct in-depth interviews with people living with HIV as well
as other key stakeholders including community
organisations, service providers and policy makers. We will
work closely with an advisory group of people living with HIV
to help guide our research as it develops, and who will be
involved in each step of the study - designing our approach,
guiding analysis and interpretation, and disseminating
results.
The findings will be shared with our collaborators at PHE to
provide evidence for future policy and to inform clinical care
in order to improve the experience of people living with HIV
accessing health and social care services as well as end-user
organisations that support people living with HIV.