The SHIELD Study
Research type
Research Study
Full title
Securing best health outcomes for people living with HIV through optimal engagement with care: Learning from Disruptive change (the SHIELD Study)
IRAS ID
308861
Contact name
Rageshri Dhairyawan
Contact email
Sponsor organisation
Joint Research Management Office, Barts Health NHS Trust
Duration of Study in the UK
2 years, 11 months, 30 days
Research summary
People living with HIV (PLH) can have a normal life expectancy and will not pass on the virus to others if they take treatment every day. However, there is still no cure for HIV and to stay well, they must take treatment and regularly attend clinic for the whole of their lives. This can be difficult for some individuals and is a major challenge to ending the HIV epidemic. In 2018, 2000 PLH in the UK were not attending clinic and a further 8100 were not on effective treatment, representing approximately 10% of PLH in the UK. Disengagement from care is an important, cause of HIV-related death and disability that may be preventable if better understood.
Unexpectedly, with the arrival of COVID-19, Barts Health and other HIV clinics across London observed that PLH who had disengaged from care were contacting them spontaneously to restart treatment. This startlingly positive and important finding will be investigated within this proposal.
We propose a study across London to explore factors that influence disengagement and re-engagement from the viewpoint of service users and service providers. We will evaluate our pre-existing policies and specialised services for these service users. We will explore the disruptive change of COVID-19 from the first 6 months and the subsequent 24 months of the pandemic in London HIV clinics. Then, using a questionnaire and interviews we will explore the factors associated with re-engagement and disengagement from HIV care. In particular, we will look at how these factors may overlap in ways that will allow a better understanding of the lived experiences of PLH. We will learn from COVID-19 and develop recommendations for HIV services on how to better support people living with HIV to stay in care and take treatment. These recommendations may be useful for services with other long-term conditions.
REC name
London - Chelsea Research Ethics Committee
REC reference
22/LO/0486
Date of REC Opinion
27 Jul 2022
REC opinion
Further Information Favourable Opinion