Attitudes and practices of physicians caring for HIV-infected children.
OBJECTIVE
The objective of our study was to describe the practices and attitudes of physicians who manage children with HIV infection.


METHODS
A 32-question survey was sent to the medical directors of 256 pediatric HIV centers.


RESULTS
Fifty-four percent of centers responded. Seventy-two percent of practitioners had been involved in HIV-related care for more than 5 years. The most common subspecialities of respondents were infectious diseases (37%) and general pediatrics (28%). Although 65% of respondents found their HIV practice more stressful than their other responsibilities, the majority of physicians (65%) felt that their HIV-related responsibilities enhanced their careers. Sixty-eight percent had some concern about contracting HIV and 24% had been exposed to HIV by needle stick injury. Polymerase chain reaction and HIV culture were the main diagnostic tests used, 78 and 62%, respectively. Trimethoprim/sulfamethoxazole for prophylaxis against Pneumocystis carinii pneumonia and zidovudine therapy for primary HIV infection were the first line drugs used by almost all respondents. Only 9% were using intravenous immunoglobulin routinely. Fifty-two percent routinely advocated zidovudine for prophylaxis of HIV infection with needle stick injury. Eighty-three percent of those surveyed thought that all pregnant women should be tested for HIV and 88% advocated treating mother/infant pairs with zidovudine if the mother is HIV-infected.


CONCLUSIONS
While HIV practitioners find their work stressful, the majority feel their careers are enhanced by their HIV-related work. There is agreement among most practitioners with regards to diagnostic tests, first-line drug therapies and the limited use of intravenous immunoglobulin. The vast majority of physicians advocate testing pregnant women for HIV infection and treating the mother/ infant pair with zidovudine if the mother is infected.
Siegel
R M
RM
Department of Pediatrics, St. Luke Hospital, Fort Thomas, Kentucky 41073, USA.
Rosenthal
S L
SL
Hill
T D
TD
Baker
R C
RC
D015492:AIDS Serodiagnosis; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010372:Pediatrics / Q000458:organization & administration*; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011795:Surveys and Questionnaires
D019380:Anti-HIV Agents