What types of physicians are best to treat patients with HIV?

Physicians with expertise or a specialty in HIV deliver better quality of care to patients with active HIV, reports Bruce Landon, Harvard Medical School associate professor of health care policy, and colleagues in the May 23 issue of Archives of Internal Medicine. The paper examined eight different areas of quality of care in the areas of antiretroviral drug use, screening and prophylaxis, and delivery of routine services for more than 5,200 patients with active HIV.

They found that infectious disease (ID) physicians and general medicine physicians with expertise in HIV had similar performance and delivered higher quality of care than nonexpert generalists. More than 80 percent of the patients being cared for by ID physicians were receiving highly active antiretroviral therapy, compared with 73 percent of patients of nonexpert generalists. Thirty-one percent of patients being cared for by nonexpert generalists had their viral load controlled, compared with 39 percent of patients for expert generalists and 41 percent for ID specialists. Nonexpert generalists also gave flu vaccinations less frequently and saw their patients less often. Of the 177 physicians examined in the study, 58 percent were generalists and 42 percent were ID specialists. Sixty-three percent of the generalists (37 percent overall) considered themselves expert in HIV care.

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