Trends in HIV-related consultation in Dutch general practice

New medicine against AIDS and a possible changing attitude towards AIDS wil l affect the role of the general practitioner (GP). We aim to explore and a ssess the changing role of the GP in preventing and detecting AIDS, which w ill be done by providing insight into the changing numbers and content of H IV-related consultations in the general practice. Since 1988 a representative sample of 63 Dutch GPs have participated in a n etwork. They recorded all face-to-face consultations with non HIV-infected patients in which the subject of AIDS was brought up. Timetrend analysis is used to investigate variations over time in the number and content of the consultations, GPs' actions and patients' characteristics. The influence of a rural or urban setting and the characteristics of the patients who are i nvolved are also taken into account. Until 1994 a significant increase was found in the number of consultations. In highly urban areas the number of consultations is higher and still grow ing, whereas physicians in rural areas see fewer patients every year. The m ost important topic of conversation was the request for an HIV test (74%). This figure grew over the years, as did the number of tests performed. GPs became less passive and restrictive in advising tests. The group of patient s has also changed; e.g. patients do not mostly belong to traditional risk groups anymore, and are significantly younger. AIDS seems to have become more familiar to patients and doctors. A lot of g eneral information is available from different sources. Because of this cha nge in attitude and knowledge of patients, the GPs' role as it relates to A IDS is becoming more specific in tracing infected patients and giving custo mized information to individuals. Patients visit their physicians less ofte n because of concerns about AIDS, but the GP continues to fulfil a very imp ortant role in the prevention and detection of AIDS.