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Driving Optimal Engagement With HIV Care To Improve Health Outcomes

Project Leads: Dr Rageshri Dhairyawan, Dr Sara Paparini, Professor Chloe Orkin, Professor Jane Anderson


One of the major challenges for ending the HIV epidemic is helping people who are living with HIV to get timely access to care and to stay engaged with care for the long-term (e.g. taking daily medication and regularly attending clinics).

During the COVID-19 pandemic, we noticed many people living with HIV who had previously disengaged from care were contacting clinics proactively to restart treatment. We also noticed that some people disengaged with HIV care during the pandemic. SHARE is investigating this change in behaviour in the SHIELD study.

Longstanding health disparities limit life expectancy and quality of life for many racially minoritised people in the UK. These disparities have been further compounded by COVID-19.”

Dr Rageshri Dhairyawan, Consultant in Sexual Health and HIV Medicine, Barts Health NHS Trust


In the SHIELD study, SHARE will explore the disruptive change brought about by COVID-19 on engagement in HIV care and use the lessons learnt to inform future interventions. This will include:
  • Conducting a mixed methods study across 11 selected London HIV clinics to investigate the barriers and enablers to engagement with HIV care from the perspective of service providers and service users. The selected HIV clinics will have a high proportion of service users from racially minoritised communities, who have been disproportionately affected by both HIV and COVID-19.
  • Using the findings from this research to inform future interventions that can support people to access and benefit from HIV care throughout their lives.
  • Sharing our learnings with other health services that support people with other long-term conditions, especially those that affect disadvantaged communities.


Dhairyawan R, Okhai H, Hill T, Sabin C. Antiretroviral treatment uptake and outcomes in heterosexual people living with HIV in the United Kingdom according to ethnic group. BHIVA conference abstract published in HIV MEDICINE, Nov 2020. Accepted for full publication in AIDS, 2021.

Solomon D, Tariq S, Alldis J, Burns F, Gilson R, Sabin C, Sherr L, Pettit F, Dhairyawan R. Ethnic inequalities in mental health and socioeconomic status among older women living with HIV: results from the PRIME Study. Sex Transm Infect. 2021 Mar 29:sextrans-2020-054788. doi: 10.1136/sextrans-2020-054788. Epub ahead of print. PMID: 33782143
Orkin C, Flanagan S, Wallis E, Ireland G, Dhairyawan R, Fox J, Nandwani R, O’Connell R, Lascar M, Bulman J, Reeves I, Palfreeman A, Foster GR, Ahmad K, Anderson J, Tong CY, Lattimore S. Incorporating HIV/hepatitis B virus/hepatitis C virus combined testing into routine blood tests in nine UK Emergency Departments: the “Going Viral” campaign. HIV Med. 2016 Mar;17(3):222-30. doi: 10.1111/hiv.12364. PMID: 26919291

Pralat R, Burns F, Anderson J, Barber TJ. Can HIV-positive gay men become parents? How men living with HIV and HIV clinicians talk about the possibility of having children. Sociol Health Illn. 2021 Feb;43(2):281-298. doi:10.1111/1467-9566.13218. Epub 2020 Nov 22. PMID: 33222191

Rosenfeld, D., & Anderson, J. (2020). ‘The own’ and ‘the wise’ as social support for older people living with HIV in the United Kingdom. Ageing and Society, 40(1), 188-204. doi:10.1017/S0144686X18000909

Safreed-Harmon K, Anderson J, Azzopardi-Muscat N, Behrens GMN, d’Arminio Monforte A, Davidovich U, Del Amo J, Kall M, Noori T, Porter K, Lazarus JV. Reorienting health systems to care for people with HIV beyond viral suppression. Lancet HIV. 2019 Dec;6(12):e869-e877. doi: 10.1016/S2352-3018(19)30334-0. Epub 2019 Nov 24. PMID: 31776099

Bristowe K, Clift P, James R, Josh J, Platt M, Whetham J, Nixon E, Post FA, McQuillan K, Ní Cheallaigh C, Murtagh F, Anderson J, Sullivan AK, Harding R. Towards person-centred care for people living with HIV: what core outcomes matter, and how might we assess them? A cross-national multi-centre qualitative study with key stakeholders. HIV Med. 2019 Sep;20(8):542-554. doi: 10.1111/hiv.12758. Epub 2019 Jun 4. PMID: 31162817

Leber W, McMullen H, Anderson J, Marlin N, Santos AC, Bremner S, Boomla K, Kerry S, Millett D, Mguni S, Creighton S, Figueroa J, Ashcroft R, Hart G, Delpech V, Brown A, Rooney G, Sampson M, Martineau A, Terris-Prestholt F, Griffiths C. Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised controlled trial. Lancet HIV. 2015 Jun;2(6):e229-35. doi: 10.1016/S2352-3018(15)00059-4. Epub 2015 Apr 28. PMID: 26423195

Baggaley RF, Irvine MA, Leber W, Cambiano V, Figueroa J, McMullen H, Anderson J, Santos AC, Terris-Prestholt F, Miners A, Hollingsworth TD, Griffiths CJ. Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis. Lancet HIV. 2017 Oct;4(10):e465-e474. doi: 10.1016/S2352-3018(17)30123-6. Epub 2017 Jul 30. PMID: 28768604; PMCID: PMC5614770

The future of HIV services in England:
A Baylis, D Buck, J Anderson, J Jabbal, S Ross; London: King’s Fund 2017

Get in touch

If you’d like more information about research theme two, please contact the project leads:

Dr Rageshri Dhairyawan
Email rageshri.dhairyawan@nhs.net

Professor Chloe Orkin
Email c.m.orkin@qmul.ac.uk

Professor Jane Anderson
Email janderson@nhs.net

Dr Sara Paparini
Email: s.paparini@qmul.ac.uk