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

Objective. The aim of this study was to compare the primary care experience s 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 cent res and 14 HIV support organizations in 11 European countries participated in the distribution of questionnaires. Overall, 1366 completed questionnair es were included in the analysis from a total of 2751 distributed (50% resp onse 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 provi sion, satisfaction with current service provision and reasons for non-invol vement of the primary care services. Results, Most patients (64.8%) had visited their GP at least once in the pr eceding 6 months, but 53.9% of respondents reported that their GP was not i nvolved 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 h ave seen their GP than their counterparts from northern and southern countr ies (P < 0.005), and were less worried that the GP would not have enough kn owledge 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 p rimarily patients' attitudes and beliefs. Strategies to promote the involve ment of primary health care services need to address patients' core beliefs , if these are to be changed.