“We need educational initiatives about HIV in primary care”

The epidemic spread like a wet blanket over health care in Sweden and the impact of displacement was significant – perhaps even greater for people living with HIV. Many doctors and researchers who were previously full-time HIV patients are now working with the coronavirus.

The Swedish government has signed on to the 2030 Agenda, in which one of the sustainable goals is to eliminate HIV and AIDS by 2030.

Read more: Promising results in Sweden-backed HIV study

Copenhagen is now the first Scandinavian country to join the Fast Track Cities Initiative, an initiative of the United Nations agency Unaids, among others, which aims to have the world’s cities eliminate HIV and AIDS by 2030. Copenhagen, for example Target Unaids for HIV: 95-95-95, i.e. 95% of people living with HIV should be diagnosed, 95% of them should be treated with HIV medication and 95% of them should be They have an unmeasurable virus level, and thus HIV is free of infection. Copenhagen is now investing generously in HIV testing.

Sweden is one of the worst countries in Europe for detecting HIV at an early stage. (1) Today we barely reach the first 90 goals; Diagnosed in 90 percent of people infected with HIV. (2)

Significant portions of HIV care are now being redirected so that all non-HIV care land is now redirected to primary care, meaning that patients with HIV have to turn to a health center or GP when they fall ill – something that spreads anxiety among people living with HIV.

This concern has been demonstrated to be justified, and a survey (3) conducted by the patient organization Posithiva Gruppen during winter 2020/2021 shows that regarding the division of responsibilities between HIV care and primary care, the extent to which the descriptions of areas of current responsibilities and procedures are consistent with patients’ experience.

The survey shows that care for people living with HIV looks different in regions of Sweden, which creates unequal conditions for accessing quality care. Also, 70 percent of the more than 100 people living with HIV who participated in the Posithiva group survey answered that knowledge about HIV in primary care is low, and 45 percent stated that treatment in primary care is poor.

Ignorance of primary care and care staff attitudes toward people living with HIV can lead to poor quality care, and even pure discrimination – all of which contribute to stigma. Are staff able to assess whether a patient with HIV’s symptoms are related to his or her HIV infection or treatment? With more and more doctors involved in primary care, there is a risk that people living with HIV must become medical experts to ensure they receive appropriate care.

Our recommendations on how Sweden should achieve the goals of the 2030 Agenda on HIV:

• We need to test for HIV frequently, even among new groups, to find people who do not know their HIV status and are therefore not undergoing treatment. One suggestion is to include HIV testing in your regular health check.

• Large cities in Sweden should join the Fast Track Cities Initiative, which aims to achieve a vision of zero new HIV cases by 2030.

• We need HIV education initiatives in primary care in order to provide patients with coherent, knowledge-based care. This increase in knowledge is also necessary to address the specific challenges and care needs that affect the cohort of elderly people living with HIV.

To the government, with Social Affairs Minister Lena Hallingren at the helm of health care issues, we send out an appeal that we need a National HIV Action Plan that governs regions’ efforts to avoid regional differences and unequal HIV care.

Peter Menhal, chief expert on HIV issues and politics, Posithiva Gruppen