Effect of physician specialty on counseling practices and medical referral patterns among physicians caring for disadvantaged human immunodeficiency virus-infected populations.
Data regarding the care and management of human immunodeficiency virus (HIV)-infected patients provided by infectious diseases (ID)-trained physicians, compared with data for care and management provided by other specialists, are limited. Here, we report results of a self-administered survey sent to 317 physicians (response rate, 76%) in 4 metropolitan areas of the United States who were identified as providing care to disadvantaged HIV-infected patients. ID-trained physicians who responded that they strongly agreed or somewhat agreed that they had enough time to care for their HIV-infected patients were more likely than were non-ID-trained physicians to provide therapy-adherence counseling. Physicians with >or=50 patients in care and ID-trained physicians were less likely to always discuss condom use and risk reduction for HIV transmission. Factors significantly associated with referring rather than treating HIV-infected patients with hypertension or diabetes included having <50 patients in care, being an ID-trained physician, and practicing in a private practice. These results suggest the need for targeted physician training on the importance of HIV transmission prevention counseling, increasing the duration of patient visits, and improving strategies for generalist-specialist comanagement of HIV-infected patients.
Duffus
W A
WA
Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30303, USA.
Barragan
M
M
Metsch
L
L
Krawczyk
C S
CS
Loughlin
A M
AM
Gardner
L I
LI
Anderson-Mahoney
P
P
Dickinson
G
G
del Rio
C
C
D023241:Antiretroviral Therapy, Highly Active; D003376:Counseling; D004645:Empathy; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D008511:Medicine; D010820:Physicians; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D013038:Specialization