Patients with HIV/AIDS: physicians' knowledge, attitudes, and referral practices.

BACKGROUND: This study investigated Massachusetts family physicians' current care and referral practices with respect to HIV/AIDS patients and examined actors that might influence family physicians in referring these patients to specialists. Educational opportunities for physicians with regard to HIV were also examined.

METHODS: In 1994, a 2-page survey was mailed to the 468 members of the Massachusetts Academy of Family Physicians. The survey questionnaire examined such factors as whether the respondents were teaching or nonteaching, rural or urban; number of years since medical school or residency training; and knowledge and attitudes with regard to HIV/AIDS patients. The data were analyzed using Student's t test, chi-square, and correlation analysis.

RESULTS: Usable responses were returned by 281 (60%) of the physicians surveyed. Of these, 65% reported having HIV patients in their practice, and 46% reported having AIDS patients was being managed alone by 53% of these physicians, and 11% managed their patients with AIDS. Physicians providing care for HIV/AIDS patients were more likely to be practicing in urban locations, have three or more HIV/AIDS patients in their practice, or recently graduated from residency. Additionally, they were more likely to be involved in residency teaching programs. Those who did not care for HIV/AIDS patients felt less knowledgeable about HIV/AIDS care, and felt that they had no time in their practice to care for this population of patients. Physicians with HIV patients learn more about HIV care from their colleagues than those without HIV patients.

CONCLUSIONS: Family physicians are increasingly seeing HIV/AIDS patients in their offices. The majority are continually caring for these patients, either by themselves or co-managing their care with a specialist. Local CME programs relying on colleagues and community resources to discuss management of these patients may be one of the best ways of ensuring that increasing numbers of family physicians obtain the appropriate knowledge to care for these patients within their own communities.