{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:44:21Z","timestamp":1792125861881,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe prior engagement in HIV care among people with HIV admitted to hospital in the United Kingdom and to examine clinical characteristics and causes of admission by engagement status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A national audit of adult HIV services was conducted across the United Kingdom in 2023. Participating centres undertook case\u2010note review of up to 20 recent hospital admissions involving people with HIV. Individuals were categorized into groups based on engagement in care: new diagnosis, regularly attending, irregularly attending (missed \u22651 HIV clinic appointment in past 12\u2009months) and not attending (not seen in HIV care for &gt;12\u2009months). Demographic, clinical and psychosocial data were collected. Analyses were descriptive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data were available for 975 admissions from 85 centres. Overall, 22% of people were a new diagnosis, 21% irregular attenders and 17% not in HIV care. People with sub\u2010optimal engagement more frequently had viraemia and immunosuppression; 86% of those not attending and 92% of newly diagnosed individuals had viral load &gt;200 copies\/mL, and 73% in both groups had CD4\u2009\u2264\u2009200 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      . AIDS\u2010defining illnesses accounted for 29% of admissions and were more commonly observed among those newly diagnosed (53%) and not attending care (40%). Psychosocial factors were frequently reported, particularly among irregular attenders (mental health issues 51%, substance use 42%, housing instability 34%). Missed opportunities for earlier diagnosis or re\u2010engagement were identified in 17% of cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospital admissions in people with HIV commonly occur in the context of late diagnosis and sub\u2010optimal engagement in care. Interventions to improve testing, retention and re\u2010engagement, particularly those addressing psychosocial barriers, may help reduce preventable morbidity and support progress towards HIV elimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70330","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:51:43Z","timestamp":1792122703000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>BHIVA Audit<\/scp>\n                    2023: Prior engagement in\n                    <scp>HIV<\/scp>\n                    care among people living with\n                    <scp>HIV<\/scp>\n                    admitted to hospital"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5375-3223","authenticated-orcid":false,"given":"Thomas","family":"Juniper","sequence":"first","affiliation":[{"name":"Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Stuart","sequence":"additional","affiliation":[{"name":"British HIV Association  Letchworth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-698X","authenticated-orcid":false,"given":"Ranjababu","family":"Kulasegaram","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5741-6359","authenticated-orcid":false,"given":"Fiona","family":"Windebank","sequence":"additional","affiliation":[{"name":"Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5173-2760","authenticated-orcid":false,"given":"Caroline","family":"Sabin","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9105-2441","authenticated-orcid":false,"given":"Fiona","family":"Burns","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"},{"name":"Royal Free London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the BHIVA Audit & Standards Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"HIV Action Plan monitoring and evaluation framework 2024 report: Report summarising progress from 2019 to 2023","author":"Schoemig V","year":"2024"},{"key":"e_1_2_7_3_1","volume-title":"Global AIDS Strategy 2026\u20132031","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2026"},{"key":"e_1_2_7_4_1","volume-title":"Towards Zero: an Action Plan towards Ending HIV Transmission, AIDS and HIV\u2010Related Deaths in England \u2013 2022 to 2025","author":"Department of Health and Social Care","year":"2021"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.2105\/AJPH.2008.139931","article-title":"Hospitalized HIV\u2010infected patients in the era of highly active antiretroviral therapy","volume":"99","author":"Metsch LR","year":"2009","journal-title":"Am J Public Health"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/QAD.0000000000001373","article-title":"Association between engagement in\u2010care and mortality in HIV\u2010positive persons","volume":"31","author":"Sabin CA","year":"2017","journal-title":"AIDS (London, England)"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1111\/hiv.13538","article-title":"Reaching zero: retention in HIV care is critical","volume":"24","author":"Waters L","year":"2023","journal-title":"HIV Med"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1016\/S2352-3018(15)00137-X","article-title":"Causes of hospital admission among people living with HIV worldwide: a systematic review and meta\u2010analysis","volume":"2","author":"Ford N","year":"2015","journal-title":"Lancet HIV"},{"key":"e_1_2_7_9_1","unstructured":"British HIV Association Standards of care for people living with HIV 2018. [cited 28 Apr 2025]. Available:https:\/\/bhiva.org\/standards-of-care-2018\/"},{"key":"e_1_2_7_10_1","volume-title":"Disruption in Services for HIV, Viral Hepatitis and Sexually Transmitted Infections during the COVID\u201019 Pandemic in the WHO European Region: a Scoping Review","author":"World Health Organization. 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Available:https:\/\/www.gov.uk\/government\/publications\/bloodborne-viruses-opt-out-testing-in-emergency-departments\/public-health-evaluation-of-bbv-opt-out-testing-in-eds-in-england-24-month-interim-report"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2019.1698704"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1016\/S2352-3018(22)00363-0","article-title":"Recommendations for defining preventable HIV\u2010related mortality for public health monitoring in the era of getting to zero: an expert consensus","volume":"10","author":"Croxford SE","year":"2023","journal-title":"Lancet HIV"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70330","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70330","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:51:46Z","timestamp":1792122706000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":18,"alternative-id":["10.1111\/hiv.70330"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70330","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2026-06-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hiv.70330"}}