Primary care physicians and AIDS. Attitudinal and structural barriers to care.
OBJECTIVE
To explore the extent to which primary care physicians are providing health care for people with human immunodeficiency virus (HIV) infection and to document barriers to HIV care giving.


METHODS
National random-sample mailed survey.


METHODS
Population-based random sample of 2004 US general internists, family physicians, and general practitioners in 1990. Response rate was 59%.


METHODS
HIV treatment experience, willingness to treat HIV-infected patients, negative attitudes toward homosexuals and intravenous drug users, fear of contagion of the acquired immunodeficiency syndrome (AIDS), perceived lack of information about AIDS, and time demands of HIV care.


RESULTS
Most physicians (75%) had treated one or more patients with HIV infection. A majority (68%) believed that they had a responsibility to treat people with HIV infection, yet half (50%) indicated that they would not, if given a choice. Over 80% of respondents believed that they lacked information about AIDS and that caring for people with AIDS is time consuming. Further, 35% of respondents agreed that they "would feel nervous among a group of homosexuals" and 55% expressed discomfort about having intravenous drug users in their practice. Physicians who had treated 10 or more HIV-infected patients expressed less negativity toward members of these stigmatized groups who are likely to be HIV infected.


CONCLUSIONS
These data suggest that many primary care physicians are responding professionally to the AIDS epidemic but that attitudinal barriers may be hindering some physicians from providing treatment to HIV-infected patients.
School of Dentistry, Center for AIDS Prevention Studies, University of California, San Francisco 94143-0754.
B
B
Gerbert
B T
BT
Maguire
T
T
Bleecker
T J
TJ
Coates
S J
SJ
McPhee
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology* / Q000628:therapy; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D011897:Random Allocation; D016079:Refusal to Treat; D015819:Substance Abuse, Intravenous; D014481:United States