To date, antiretroviral therapy for HIV-infected patients in the UK has been managed almost exclusively by specialists in secondary care. However, changes in the disease's nature challenge this approach. High rates of new diagnoses (6,750 in 2010),1 earlier initiation of therapy and increased life expectancy have led to a growing and ageing cohort of patients. Estimates suggest that by 2012 over 100,000 people in the UK will have HIV infection, with one in five being aged over 50 years.2,3 HIV infection has therefore become a chronic disease requiring lifelong treatment. Such changes should prompt a re-evaulation of …