HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN PATIENTS OLDER THAN 50 YEARS - A SURVEY OF PRIMARY-CARE PHYSICIANS BELIEFS, PRACTICES, AND KNOWLEDGE

To assess primary care physicians' attitudes, knowledge, and practices with respect to the human immunodeficiency virus (HIV) in older patie nts, a prospective survey of a representative cohort of primary care p hysicians was conducted in Dallas County, Texas, a large metropolitan area. Three hundred thirty primary care physicians participated in the survey. Questions were asked regarding physician demographics, practi ce characteristics, and knowledge and practices with respect to HIV an d the acquired immunodeficiency syndrome (AIDS) in patients older than 50 years. The responses of the following groups were compared: family practitioners vs internists, physicians younger than 40 years vs thos e aged 40 years and older, those who saw 5 or less vs more than 5 pati ents with HIV or AIDS per year, and those in private vs nonprivate pra ctice. Most respondents (85.5%) reported having seen 10 or fewer patie nts with HIV or AIDS in the previous year. Most physicians (69.7%) rep orted that patients older than SO years rarely or never asked question s concerning HIV or AIDS. Most physicians rarely or never discussed HI V or AIDS with patients older than SO years (60.8%) and rarely or neve r discussed risk factor reduction (67.5%). Physicians were more likely to rarely or never ask patients older than SO years compared with tho se younger than 30 years about HIV risk factors (40.0% vs 6.8%, P<.001 ). Physicians incorrectly rank ordered the most prevalent risk factors in patients older than 50 years. The correct order is (I) male-male s ex, (2) intravenous drug use, (3) blood transfusion, and (4) heterosex ual sex. Physicians aged 40 years and older were more likely to correc tly identify the most prevalent risk factor (P=.03). Family practition ers were more likely to rarely or never ask older patients about risk factors for HIV (54.9% vs 28.9%, P=.007). Primary care physicians have inadequate knowledge concerning HIV and AIDS risk factors in older pa tients and insufficiently discuss HIV and AIDS with older patients. Ph ysicians should counsel patients of all ages about HIV and AIDS.