HIV treatment and support

If you’ve had unprotected sex and think you may have been exposed to HIV it’s important to act quickly.

HIV transmission can be stopped in its tracks through a course of treatment soon after unprotected sex. The treatment must be started within 72 hours (three days) following exposure to HIV. You will need to be seen by a doctor in a clinic or at any Accident & Emergency department if the clinics are closed.

This treatment requires tablets to be taken once or twice a day for 28 days to be successful.

Find your nearest clinic in Medway or Kent or contact the Sexual Health Service for more information and support.

If you are living with HIV and have been receiving your care at another HIV centre but wish to transfer to our service, please contact us.

We will arrange for you to meet the nurse for your clinic, do an HIV test and any other tests we need to confirm your diagnosis, and contact your old treatment centre for information about your treatment there. We will book you an appointment with a consultant, if you need one. It is really helpful if you still have a few months of medication left when you first make contact so there is no risk of running out before your appointment.

We know that many people living with HIV suffer from stigma because of their condition. While some are very open and ‘out’ about their diagnosis, other people have told no one or just one or two people. We would like to reassure you that your care in our service is confidential. Our notes are not accessible to anyone outside of the HIV Service.

We routinely write to your GP and to other healthcare professionals involved in your care as this helps to keep your treatment safe, so please let us know if you do not want us to do this.

We do not give out any information about you without your consent, other than in extremely rare situations such as where we have to by law or for safeguarding purposes if anyone was in danger.

We see most of our patients every six months, but you will be seen more often if needed, and some patients may require only a yearly review.

Please have your blood tests two weeks before your appointment so the results are ready when you are seen. How you get your blood tests varies by clinic due to practicalities such as rooms available to us, so we offer blood taking clinics, going to the local hospital phlebotomy service or in some cases, attending your GP surgery.

We offer face-to-face or telephone appointments, and hope to offer video consultations in the near future. We will discuss what will suit you best, but our consultants like to see you face-to-face at least once a year.

Once your HIV has become undetectable and your CD4 count is over 350 cells for a year we no longer need to routinely check your CD4 count as we know it doesn’t drop, as long as you keep taking your treatment.

If you have an urgent medical problem please contact us for advice.

Out of hours you can call NHS 111 or in an emergency call 999.

If you are admitted to hospital for any reason, please call your HIV nurse or The Gate Clinic to let them know. Our nurses can visit you on the ward, and our Pharmacy Team can liaise with the hospital to make sure you get the right medication. Our doctors can also advise the hospital doctors on your management. If you have a more complex HIV-related illness, the team will also liaise with the HIV Team at Chelsea and Westminster Hospital. Sometimes our patients are transferred there to get expert treatment.

Anyone diagnosed with HIV will be treated with antiretroviral medication. The aim of treatment is to prevent you getting ill, and the medication does this by reducing the amount of the virus in your blood so it is undetectable. When this has happened, your immune system can recover, which we can measure by checking your CD4 count. It can stop you passing the virus on to anyone else.

There are many different drugs available and we will involve you in deciding which ones are right for you. Some are one pill once-a-day, some need you to have eaten food or have an empty stomach, some have interactions with other medication, and some may have other side effects that make them a bad choice if you have other medical conditions. We will work to get you onto treatment that will work well and have the minimum impact on your life.

We will need to see and monitor you more frequently when you start or change treatment. Our Pharmacy Team offer support and advice on managing any side effects or other problems you might have.

High street pharmacies do not normally have access to HIV drugs so you can’t get your medication on a GP prescription. Instead, we will need to prescribe the medication for you.

We use a company called Alcura for our medication. They offer the option of delivering to your home or other address, or they will deliver it to a specified pharmacy that you can collect from.

When you start or change treatment, we may need to prescribe it through your local hospital, so at times you may need to collect from the hospital pharmacy. We try to keep this to a minimum.

We always try to make sure you have enough medication to last until your next appointment, plus a spare month’s supply so that you don’t run out if there is any delay.

You can make sure you don’t run out of medication by attending for your blood tests when they are due, and then attending your appointment. If you don’t do this we won’t be able to prescribe the medication, and Alcura will not deliver anything.

If you ever find that you have only two weeks or less of medication left, please contact your HIV nurse or The Gate Clinic. It can take a while to see you, check your results, write and check the prescription before it goes to Alcura, who then have to prepare pack and deliver the medication. We can sometimes get urgent medication through the local hospital, but even this can take a few days.

There can be significant drug interactions between many common medications and HIV drugs. You can call one of our Pharmacy Team to check if there is an interaction, or you could check these out yourself on Liverpool.org.uk. We always include details of this website on letters to your GP. There may also be interactions with herbal treatments or drugs you can buy, so please check with us if you are unsure.

Our HIV service is part of an integrated Sexual Health Team, which means we also provide STI testing and treatment, contraception and psychosexual therapy. We want you to have safe and enjoyable sex lives, free from risk of STIs or unwanted pregnancy. If you are sexually active we would recommend an annual STI screen, and this should be more frequently if you have multiple partners or when you have a new partner. If you don’t have any symptoms this can be done by requesting a free and confidential online testing kit via www.sh.uk. If you do have symptoms you should contact us for further advice.

For women, it is recommended that you have cervical screening (smear test) every year until you reach 65. We may be able to arrange this in clinic if you are having problems getting this from your GP. We offer the full range of contraception, and it is best to discuss this with us in case of drug interactions with your medication which might make some methods less effective for you.  If you are considering getting pregnant, or think you are pregnant, please let us know as soon as possible so we can make sure you get the best care. You can also ask our advice as you approach the menopause.

Please note that we may not be able to provide STI testing and treatment, contraception and manage your HIV in one appointment so you may need to return for these services.

Remember that once you have been on treatment with an undetectable HIV viral load, you can no longer pass HIV to a sexual partner. This is known as U=U or undetectable = untransmissible. We would however still recommend condoms as this will protect you against other sexually transmitted infections.

HIV is passed on through sex, through blood (for example sharing needles for drug use) and from a mother to her unborn child. Anyone who is newly-diagnosed with HIV must have got it from someone else, so we will try to work with you to see if there are any contacts who should be tested. As it is likely you will still be processing your diagnosis yourself, this will be handed sensitively and your confidentiality will be respected.

It is now entirely possible that, with the right care, respect and support, women living with HIV can have babies born HIV-free through normal vaginal delivery. If you want to get pregnant or breastfeed, please let us know as we can give advice and check that any medication is safe to get pregnant or breastfeed while taking.

4M Mentor Mothers is a unique peer-led programme led by Black migrant women who train women living with HIV across the UK as Mentor Mothers to provide psycho-social support to peers in their pregnancy journey and beyond.

• Hepatitis
  We offer vaccination against hepatitis A and B to all our non-immune patients.
• HPV vaccine
  Human Papilloma Virus (HPV) causes many different types of cancer, including cancer of the cervix, anus and throat. We offer the HPV vaccine to men who have sex with men who are aged 45 and under. Girls and now boys are now offered this vaccine in school.
• Covid-19
  We strongly recommend that you are vaccinated against COVID 19 as this infection can be more severe in individuals with HIV. This would be given through your GP surgery. Please ask us for the most up-to-date advice on this as it is changing as more is known about the virus.
• Flu vaccine
  You should have influenza (flu) vaccine every year from your GP. We will write and ask your GP to add you to their list of patients eligible for annual vaccination. If your GP does not know your HIV status we recommend you pay to get vaccinated at a pharmacy.
• Pneumococcal Vaccine
  All individuals who are living with HIV are recommended to be vaccinated against pneumococcus as HIV can cause severe pneumonia. We will write to your GP and request that they give you a single dose of pneumococcal vaccine with Prevenar-13.When you reach the age of 65 your will be offered a different pneumococcal vaccine PPSV23, and we recommend that you accept this vaccine on top of the Prevenar-13 you have already had as this gives extra protection against severe pneumonia.If you are unsure about other vaccines please just ask one of the team for advice.

We ask:

• you attend appointments when you have them, or let us know if you can’t attend as soon as possible. We are quite busy and can usually book someone else into the slot with enough notice. Please contact us if you can’t attend.
• where possible you have blood tests two weeks before your appointment so that we can discuss the results with you.
• you to take your medication as advised. If you struggling with it please let us know so we can help.
• you let us know if you have only two weeks or less medication left, as it takes a while to organise delivery of more medication and we do not want you to run out.
• you let us know of any changes in your circumstances, such as if you move house or have a new phone number.
• you treat all our staff with respect, as threatening behaviour will not be tolerated.

Research

Research is very important in improving services and treatment for patients, so we often take part in research studies. We may ask you to take part, but it is entirely up to you if you wish to or not, and declining to do so will never affect your care.