       Document 0038
 DOCN  M9610038
 TI    Prevention of HIV infection in primary care: current practices, future
       possibilities.
 DT    9601
 AU    Makadon HJ; Silin JG; Division of General Medicine and Primary Care,
       Beth Israel; Hospital, Boston, MA 02215, USA.
 SO    Ann Intern Med. 1995 Nov 1;123(9):715-9. Unique Identifier : AIDSLINE
       MED/96011280
 AB    More than a decade has passed since the human immunodeficiency virus
       (HIV) and the acquired immunodeficiency syndrome (AIDS) epidemic began;
       our failure to develop an effective vaccine and adequate medical
       treatments indicates that future research and practice must work to
       prevent the spread of HIV. We review the literature on the current
       HIV-prevention practices of primary care physicians and highlight
       opportunities for clinical prevention. Prevention is hindered in four
       ways: 1) by narrow conceptions of medical care and of the role of the
       physician; 2) by physicians' discomfort with discussing human sexuality
       and illicit drug use and their attitudes toward persons with HIV or
       AIDS; 3) by constraints on time and resources; and 4) by the ambiguity
       of HIV prevention messages. We suggest strategies to overcome these
       barriers, including modifications in public policy, health care delivery
       systems, and medical education. These strategies support a
       nonhierarchical physician-patient relationship, with attention to
       culture and values, that will help physicians to identify and work with
       persons at increased risk for HIV infection.
 DE    Attitude of Health Personnel  Human  HIV Infections/*PREVENTION &
       CONTROL  *Physician's Practice Patterns  *Physician's Role  *Physicians,
       Family  Support, Non-U.S. Gov't  Time Factors  United States  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

