Skip to main content
NCBI home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1998 May;48(430):1233–1236.

The role of the general practitioner in the community care of people with HIV infection and AIDS: a comparative study of high- and low-prevalence areas in England.

M King 1, R Petchey 1, S Singh 1, L Wright 1, J Raab 1, W Farnsworth 1, J Williams 1, K Friedli 1
PMCID: PMC1410172  PMID: 9692281

Abstract

BACKGROUND: Policy for the care of people suffering from HIV and AIDS has changed over the past decade. Schemes for shared primary and secondary care have been met with varying success, and patients may be reluctant to become involved. No systematic evaluation comparing the views of primary care providers and users in areas of varying HIV prevalence has been published. AIM: To examine the role of general practice in areas of England with low and high human immunodeficiency virus (HIV) prevalence and to compare barriers to general practice care in each area. METHOD: We used focus groups, semistructured questionnaires and interviews in north London (high HIV prevalence) and Nottingham (low HIV prevalence). RESULTS: Four focus groups took place in London. A total of 411 general practitioners (GPs) in London and 405 in Nottingham replied to postal questionnaires. Overall, 121 primary care staff in 40 London practices and 26 staff in five Nottingham practices were interviewed. In all, 54 people infected with HIV were interviewed in London and 20 in Nottingham. Providers and users regarded the 24-hour availability and the familiar environment of general practice as its key assets. Lack of expertise and time were its disadvantages. Providers were concerned about inadequate communication with specialist services. Although providers were concerned about confidentiality, whether they had liberal and sympathetic attitudes was more important in deciding whether people with HIV used the service. In the low-prevalence area, general practice involvement was the result of individual initiatives, and practices were not integrated into specialist care. In the high-prevalence area, HIV care was more usual in general practice, but there was also little integration with HIV services. CONCLUSIONS: In high-prevalence districts, a strategy to make HIV care routine for all GPs may be appropriate. In low-prevalence areas, a network of selected, strategically located, relatively high-involvement practices may be more effective in meeting the primary care needs of people with HIV infection and acquired immunodeficiency syndrome (AIDS).

Full text

PDF
1233

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown-Peterside P., Sibbald B., Freeling P. AIDS: knowledge, skills and attitudes among vocational trainees and their trainers. Br J Gen Pract. 1991 Oct;41(351):401–405. [PMC free article] [PubMed] [Google Scholar]
  2. Clarke A. E. Barriers to general practitioners caring for patients with HIV/AIDS. Fam Pract. 1993 Mar;10(1):8–13. doi: 10.1093/fampra/10.1.8. [DOI] [PubMed] [Google Scholar]
  3. Gallagher M., Foy C., Rhodes T., Philips P., Setters J., Moore M., Naji S., Donaldson C., Bond J. HIV infection and AIDS in England and Wales: general practitioners' workload and contact with patients. Br J Gen Pract. 1990 Apr;40(333):154–157. [PMC free article] [PubMed] [Google Scholar]
  4. Grun L., Murray E. Acceptability of shared care for asymptomatic HIV-positive patients. Fam Pract. 1995 Sep;12(3):299–302. doi: 10.1093/fampra/12.3.299. [DOI] [PubMed] [Google Scholar]
  5. Guthrie B., Barton S. HIV at the hospital/general practice interface: bridging the communication divide. Int J STD AIDS. 1995 Mar-Apr;6(2):84–88. doi: 10.1177/095646249500600204. [DOI] [PubMed] [Google Scholar]
  6. King M. B. Psychological and social problems in HIV infection: interviews with general practitioners in London. BMJ. 1989 Sep 16;299(6701):713–717. doi: 10.1136/bmj.299.6701.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Mansfield S., Singh S. Who should fill the care gap in HIV disease? Lancet. 1993 Sep 18;342(8873):726–728. doi: 10.1016/0140-6736(93)91714-w. [DOI] [PubMed] [Google Scholar]
  8. Paauw D. S., Wenrich M. D., Curtis J. R., Carline J. D., Ramsey P. G. Ability of primary care physicians to recognize physical findings associated with HIV infection. JAMA. 1995 Nov 1;274(17):1380–1382. [PubMed] [Google Scholar]
  9. Roderick P., Victor C. R., Beardow R. Developing care in the community: GPs and the HIV epidemic. AIDS Care. 1990;2(2):127–132. doi: 10.1080/09540129008257723. [DOI] [PubMed] [Google Scholar]
  10. Saunders D. GP facilitators and HIV infection. BMJ. 1994 Jan 1;308(6920):2–3. doi: 10.1136/bmj.308.6920.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Shaw M., Tomlinson D., Higginson I. Survey of HIV patients' views on confidentiality and non-discrimination policies in general practice. BMJ. 1996 Jun 8;312(7044):1463–1464. doi: 10.1136/bmj.312.7044.1463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Smits A., Mansfield S., Singh S. Facilitating care of patients with HIV infection by hospital and primary care teams. BMJ. 1990 Jan 27;300(6719):241–243. doi: 10.1136/bmj.300.6719.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Zuger A., Sharp V. L. 'HIV specialists': the time has come. JAMA. 1997 Oct 8;278(14):1131–1132. [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES