Treatment advances and outcomes data have raised new concerns about how to optimize care for patients with HIV infection.
This paper reviews evidence on 1) the relation between experience and type of training and patient outcomes, 2) the relation between the components of primary care and patient outcomes, and 3) primary care physicians'basic HIV knowledge and skills in screening and prevention.
Several studies indicate that greater experience in HIV care leads to improved patient outcomes.
The relation between outcomes and type of training (subspecialist or generalist) is less clear, and studies have not distinguished between type of training and experience.
Less experienced physicians may be able to provide high-quality care if appropriate consultation from expert physicians is available.
Components of primary care, including accessibility, continuity, coordination, and comprehensiveness, are associated with better patient outcomes.
Optimal care of HIV infection requires a combination of disease-specific expertise and primary care skills and organization.
Criteria for expertise in HIV management should focus on actual patient care experience and HIV expertise rather than on subspecialty training per se.
The management of HIV has become sufficiently complex that primary care physicians cannot be routinely expected to have extensive specialized knowledge in this area. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Traitement, Soin santé primaire, Médecin généraliste, Pratique professionnelle, Expérience professionnelle, Homme, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Treatment, Primary health care, General practitioner, Professional practice, Professional experience, Human, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0412941
Code Inist : 002B05C02D. Création : 22/03/2000.