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

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The treatment and care of people living with HumanImmunodeficiency Virus (HIV) has significantly improved inthe past two decades across the United Kingdom (UK).These advancements now mean that people can live with HIVfor much of their life, with few complications; it is a "chronic"(or lifelong) condition and is considered 'beyondundetectable'. Yet, differences in clinical stage at diagnosisand how people manage their other health conditions (comorbidities) alongside HIV still exist. People living with HIVhave also described an unmet need in social and welfareservices being provided, which includes services such asimmigration or employment support, and whose funding hasbeen affected by recent changes in government policies.This project looks to investigate why differences exist for thehealth and wellbeing of people living with HIV, and how muchthis can be explained by peoples' economic and socialcircumstances (their social determinants). We will alsoexplore whether recent changes in public policies, includingthose related to the reported "hostile environment" forimmigration, have also affected the experiences faced bypeople living with HIV when accessing social and welfareservices in the UK.We will use two main methods to explore these differences;firstly, analysing data from a survey conducted in 2017 byPublic Health England (PHE) of over 4,000 adults living withHIV in the UK, the Positive Voices study. Secondly, we willconduct in-depth interviews with people living with HIV as wellas other key stakeholders including communityorganisations, service providers and policy makers. We willwork closely with an advisory group of people living with HIVto help guide our research as it develops, and who will beinvolved in each step of the study - designing our approach,guiding analysis and interpretation, and disseminatingresults.The findings will be shared with our collaborators at PHE toprovide evidence for future policy and to inform clinical carein order to improve the experience of people living with HIVaccessing health and social care services as well as end-userorganisations that support people living with HIV.