This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge/training about treating HIV patients. Barriers to treating HIV infected patients is frequently reported in many countries and it is important for developing countries such as South Africa to learn from these experiences by identifying local problems so that constructive interventions and strategies can be developed to address these barriers, thereby improving the quality of patient care. Further research in respect of the local situation is required.IntroductionOver the last two decades acquired immunodeficiency syndrome (AIDS) has emerged as one of the most serious public health problems in the world, and by the end of 2003 it was estimated that 5.3 million South Africans were human immunodeficiency virus (HIV) positive, which corresponds to 21.5% of...

/pdf/barriers-to-hiv-care-and-treatment-by-doctors-a-review-of-7k0y49aex4.pdf

Barriers to HIV Care and Treatment by Doctors: A review of the literature.

Ethical dilemmas in care for HIV infection among French general practitioners

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The
four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and
inadequate knowledge /training about treating HIV patients. Barriers to treating HIV infected patients is frequently
reported in many countries and it is important for developing countries such as South Africa to learn from these
experiences by identifying local problems so that constructive interventions and strategies can be developed to
address these barriers, thereby improving the quality of patient care. Further research in respect of the local situation
is required.
 Introduction: 
Over the last two decades acquired immunodeficiency syndrome (AIDS) has emerged as one of the most serious
public health problems in the world, and by the end of 2003 it was estimated that 5.3 million South Africans were
human immunodeficiency virus (HIV) positive, which corresponds to 21.5% of the population.1 In the early phase
of the HIV epidemic few doctors saw infected patients and treatment options were limited. As a result many doctors
were reluctant to provide care to HIV infected patients and homophobia amongst doctors, fear of contact with patients
and unwillingness to care were frequently reported.2 However, there has been an exponential increase in the number
of HIV and AIDS related cases and more doctors are encountering infected individuals. This review summarizes our
current knowledge of barriers to treatment of HIV infected patients by doctors.
 Method 
A comprehensive literature review was undertaken by searching the MEDLINE database, Psychlit, ISI Web, EBSCOHost,
and Sabinet on line, for English language literature published between 1985 and 2004. The database search terms
included keywords such as fear/s, barrier/s, concern, HIV, AIDS, attitudes, physician/s (doctor/s), practice, treatment,
care and knowledge. A variety of combinations of these words were entered. All duplicate articles were removed and
only studies that used doctors as the sample population were considered. Titles expressing comment, news items,
opinion pieces or letters were rejected.
 Results 
Thirty two relevant studies were identified from the literature search. The four most commonly reported barriers were:
fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating
HIV patients.

Barriers to HIV care and treatment by doctors : a review of the literature : review article

Prevalence and detection of HIV risk behavior in primary care: implications for clinical preventive services.

Sexually transmissible infections are a major preventable health problem in Australia. This thesis examines the barriers faced by general practioners in diagnosing and treating these infections. Recommendations for more practical and effective control of sexually transmissible infections by general practioners in Victoria are made.

/pdf/general-practitioner-and-the-control-of-sexually-3sui938gvc.pdf

General practitioner and the control of sexually transmissible infections

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 60% 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.

Attitudes, knowledge and behaviour of general practitioners ir relation to HIV infection and AIDS: Commonwealth AIDS Research Grant Committee Working Party

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Attitudes, knowledge and behaviour of general practitioners ir relation to HIV infection and AIDS: Commonwealth AIDS Research Grant Committee Working Party