Attitudes, knowledge and behaviour of general practitioners in relation to HIV infection and AIDS

A stratified random sample of 655 Australian general practitioners (GPs) was surveyed to determine their attitudes, knowledge and behaviour in relation to the human immunodeficiency virus (HIV) pandemic. Of the 486 respondents, 22% had one or more patients with HIV infection in their practice and 80% had been asked for information on HIV infection in the past month by at least one patient. The majority of respondents viewed screening and education of patients as part of their role, but 24% did not want to maintain a therapeutic relationship with HIV-infected patients and 16% felt it was appropriate to refuse to treat this group. Although most respondents correctly identified the well known risk-taking behaviours for HIV infection in homosexual men and intravenous drug users, they underestimated the risk to heterosexuals and exaggerated that associated with activities generally considered not to involve risk. The knowledge of appropriate infection control procedures of approximately 60% of the respondents was inadequate. A lack of time in consulting was the most commonly cited barrier to the routine assessment of, or enquiry into, risk-taking behaviours of patients in the respondents' practices. Respondents noted that they required more knowledge of the clinical presentation and diagnosis of HIV infection, as well as education in counselling techniques and the risks of transmission associated with sexual and non-sexual activities. They felt such information could best be imparted through printed material. These results indicate that most GPs are willing to play an active role in the diagnosis, treatment and prevention of HIV disease, but they require more accurate information in order to fulfil this role appropriately. The study identifies and addresses several barriers to GPs playing a more active role in the management of HIV disease.