Image: Burnet Instiute Deputy Director, Professor Margaret Hellard AM

Burnet Institute Deputy Director, Professor Margaret Hellard AM, is among a multidisciplinary group of HIV experts from around the world who are co-authors of a Consensus Statement on the role of health systems in advancing the long-term well-being of people living with HIV.

Published in the journal Nature Communications to coincide with the 11th IAS Conference on HIV Science, the statement identifies key issues health systems must address to move beyond an emphasis on viral suppression to deliver integrated, person-centred healthcare for people living with HIV (PLHIV) throughout their lives.

“Whilst Australia’s efforts to end HIV and AIDS is making great progress through highly effective treatments and prevention, the need for a person-centred approach to ensure people living with HIV is of vital importance,” Professor Hellard said.

“This includes addressing other physical health issues and mental health issues, as well as stigma which has an enormous impact on people’s wellbeing.

“Globally, we need to increase our efforts to ensure there is equity in access to HIV and broader health care, and social services.

“The impact of poverty, social isolation, difficulty in accessing services and discriminatory laws and attitudes means that many people globally are not getting the care they deserve.

“This includes adolescent girls and young women, people from the GLBTI+ community and people who inject drugs.”

The experts note that while there’s been a decline in AIDS-related mortality and morbidity following the global scale-up of highly effective antiretroviral therapies, PLHIV often report poor well-being and health-related quality of life (HRQoL).

Negative factors include drug and alcohol dependence, poverty, social isolation, difficulties in disclosing HIV status, and persecution due to discriminatory laws and attitudes.

“These problems call for a broad health system response to the health-related needs of PLHIV,” the experts write.

“The central goal should be integrated, person-centred healthcare that promotes the importance of HRQoL, recognising the right of all people to enjoy the highest attainable standard of physical and mental health.”

To this end, the experts developed 31 Consensus points on the role of health systems in advancing the well-being of PLHIV, under four key headings:

• Framing a more comprehensive health agenda for PLHIV
• Multimorbidity
• Self-reported HRQoL, and
• Stigma and Discrimination

Recommendations from the experts include:

• The need for new clinical and public health targets in all countries to optimise resources, achieve better engagement and improve health outcomes of PLHIV
• Urgent attention from policy makers and service providers to mental and physical health comorbidities that are highly prevalent among PLHIV worldwide
• Recognition of self-reported HRQoL as a core outcome in the clinical management of individual patients, and
• Provision of information to patients in healthcare settings about their rights and channels for reporting stigmatising and discriminatory behaviours and experiences

“Prevention and treatment of HIV infection including access to ART remain a major public health and human rights challenge that requires urgent, sustained attention,” the experts conclude.

“This consensus statement addresses the concurrent role of health systems in advancing the long-term well-being of PLHIV.”

Burnet Institute is one of 68 institutes and organisations who’ve endorsed the Consensus Statement.

Find out more about Burnet’s HIV research and how you can support this important work.