STRATEGIES FOR IMPROVING PRIMARY CARE FOR HIV PATIENTS

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As the AIDS epidemic continues to spread, primary care physicians must become more involved in the care of HIV patients. Previous reports suggest that primary care physicians have expressed reluctance to care for this population because of prejudicial attitudes and deficiencies in knowledge about HIV disease. There are other issues that have not yet been explored in depth that may affect primary care physicians' motivations and willingness to care for HIV patients, such as economic and time constraints, fear of contagion and "burnout". This study will consist of in-depth interviews with community-based primary care physicians who care for patients with HIV disease, and who are likely to have identified and overcome many of the difficulties involved in HIV care. Thirty physicians will be interviewed in six small cities that are outside of the originally designated high-risk areas. The aims of the study are to examine the factors that motivate primary care physicians to care for HIV patients, to identify important difficulties encountered by primary care physicians who are caring for HIV patients, and to learn what enabled them to overcome those difficulties. The interview data will be analyzed using quantitative and qualitative ethnographic methods. Using one-way analyses of variance, correlations will be sought between demographic data and type of experience with HIV patients on the one hand, and motivations, difficulties and ways of overcoming those difficulties on the other. The results will be used to generate new hypotheses and to design interventions that will be tested in a future phase of the study.