title: [HIV infection. A chronic disease that redefines collaboration between general practitioners and specialists. A qualitative study on opportunities and obstacles to collaboration].
abstract: OBJECTIVE
  With the development of antiretroviral therapy, Human Immunodeficiency Virus [HIV) infection has become a chronic disease. In order to develop an efficient response to this new challenge, there is a need for closer collaboration between specialized units and general practitioners. This article identifies the opportunities for and the barriers to this collaboration.
  
  
  METHODS
  Semi-structured interviews were conducted with patients living with HIV, general practitioners working in multidisciplinary group practice using the capitation system and infectiologists from one Belgian urban area. Interviews focused one xperiences and expectations in relation to diagnosis, follow-up and collaboration between general practitioners and infectiologists.
  
  
  RESULTS
  Overall, infectiologists and general practitioners aspire to improved communication and collaboration. There are overlaps between general practitioner's and infectiologist's field of action. The general practitioner's intervention is sometimes restricted to common uncomplicated or psychosocial problems, in the context of unplanned and short contacts.Infectiologists prefer to focus on HIV problems, leaving general practitioners to take care of these patients' other health problems. The patient may be an obstacle to greater involvement of general practitioners due to fear of stigmatization from his family and social circle or lack of confidence in the general practitioner's skills.
  
  
  CONCLUSIONS
  This research underlines the difficulties and gaps in the care of HIV patients and provides preliminary explanations for the lack of active cooperation between general practitioners and infectiologists. Overlaps between the areas of professional skills can result in uncovered aspects of care, which can have a negative impact on patients, but also on general practitioners and infectiologists. Collaboration between general practitioners and infectiologists should be based on a concerted decision, with clear allocation of tasks, taking into account the patient's expectations.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Belche
authors.forename: Thida
authors.initials: T
authors.lastname: Kang
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ketterer
authors.forename: Marie-Astrid
authors.initials: MA
authors.lastname: Berrewaerts
authors.forename: Michel
authors.initials: M
authors.lastname: Moutschen
authors.forename: Didier
authors.initials: D
authors.lastname: Giet
mesh_terms: D000328:Adult; D001530:Belgium; D002908:Chronic Disease; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D058005:General Practitioners / Q000458:organization & administration*; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D055552:Infectious Disease Medicine; D007407:Interviews as Topic; D008297:Male; D013038:Specialization