Effect of Physician Specialty on Counseling Practices and Medical Referral Patterns among Physicians Caring for Disadvantaged Human Immunodeficiency Virus--Infected Populations

Duffus, W.A.; Barragan, M.; Loughlin, A.M.; Gardener, L.I.; Anderson-Mahoney, P.; Dickinson, G.; del Rio, C.
June 2003
Clinical Infectious Diseases;6/15/2003, Vol. 36 Issue 12, p1577
Academic Journal
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 ≥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.


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