HIV as a chronic disease: are primary care physicians ready?

Abstract

Objective: As HIV infection is becoming a chronic entity, the role of primary care physicians (PCPs) in diagnosis and treatment is getting more significant. We aimed to assess the attitude and competency of the PCPs about HIV infection compared to other specialties and describe the areas for improvement. Materials and Methods: A survey was conducted between 1-31 May 2017 among physicians from different specialties. The questions related to HIV infection in their clinical practice, competency, and knowledge about the transmission and preventability of the disease and their attitude towards suspected patients were asked. Results: We included 492 physicians in the study, consisting of PCPs (32%), infectious disease specialists (IDSs) (13%), internal medicine specialists (IMSs) (30%) and surgeons (25%), practicing in 25 different cities in Turkey. When asked about HIV, 98% of IDSs considered it as a chronic disease, with 35% thinking that it is similar to non-communicable disease (Diabetes Mellitus, Hypertension, Lymphoma). HIV was not a curable disease according to 87% of PCPs, and 21% in IDSs. The 70% of PCPs thought that HIV infection could be transmitted with vectors (p<0.001, although they self-rated their knowledge above the average. According to 34% of PCPs, HIV was transmissible through shared utensils (spoon, fork, glass), according to 50% public pools and toilets could be a source for transmission (p<0.001) Upon diagnosis, only 53% of IDSs provided psychological support to patients, and this rate declined to 1% in PCPs (p<0.001). Conclusion: The potential role of PCPs in the follow up of HIV infected patients would be increased. However, there are significant knowledge and attitude gaps related to HIV infection among PCPs in Turkey. By thinking of increasing the role of primary care, training, and education programs should be implemented for PCPs.