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

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Abstract
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.