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Family Practice Vol. 17, No. 4, 288-292
© Oxford University Press 2000

Primary care involvement in human immune deficiency virus infection—a pan-European view

David R Tomlinsona, Robert Colebundersb, Yves Coppietersb, Christa Dreezenb, Roberta Andraghettib, Yon Fleerackersb, Helmut Liessc, John Kosmidis4 and the Eurosupport Study Group

a Department of Genitourinary and HIV Medicine, St Mary's Hospital, London, UK,
b Institute of Tropical Medicine, Antwerp, Belgium,
c LMU München, Klinikum Innenstadt, München, Germany and
d First Department of Medicine, General Hospital of Athens, Greece.

R Colebunders, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium.

Objective. The aim of this study was to compare the primary care experiences of human immunodeficiency virus (HIV)-positive individuals across Europe.

Methods.An anonymous self-administered questionnaire study was carried out between August 1996 and August 1997. A total of 15 HIV/AIDS treatment centres and 14 HIV support organizations in 11 European countries participated in the distribution of questionnaires. Overall, 1366 completed questionnaires were included in the analysis from a total of 2751 distributed (50% response rate). The majority of respondents were homosexual men (53.6%), and 54.2% had AIDS or symptomatic HIV disease. The main outcome measures were use of GP services in the preceding 6 months, GP involvement in HIV care provision, satisfaction with current service provision and reasons for non-involvement of the primary care services.

Results. Most patients (64.8%) had visited their GP at least once in the preceding 6 months, but 53.9% of respondents reported that their GP was not involved in their HIV care. Of these patients, 53.4% would like their GP to be involved. Patients from central European countries were more likely to have seen their GP than their counterparts from northern and southern countries (P < 0.005), and were less worried that the GP would not have enough knowledge about HIV (P = 0.002) or would not be sympathetic (P = 0.052).

Conclusions.There are clear differences in GP utilization by HIV-positive individuals across Europe, reflecting in part local service provision but primarily patients' attitudes and beliefs. Strategies to promote the involvement of primary health care services need to address patients' core beliefs, if these are to be changed.

Keywords. Europe, HIV, primary care.


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