Calonge B N, Miller R S, Dennis L K, Joffe L S
Department of Family Medicine, University of Colorado Health Sciences Center, Denver.
J Fam Pract. 1991 Apr;32(4):369-72.
Despite the importance of the epidemic of acquired immune deficiency syndrome (AIDS), little is known about the incidence and prevalence of AIDS in the patient population of primary care physicians. This study was designed as an initial step in evaluating the impact of this disease on primary care practices.
We conducted a survey to characterize the AIDS cases in the Ambulatory Sentinel Practice Network (ASPN). ASPN is a practice-based primary care research network. In 1987 it was composed of 65 practices and 193 clinicians serving approximately 270,000 patients in the United States and Canada. Clinicians representing each practice were asked to report the number of AIDS patients that their practice cared for between January 1982 and December 1987. They were further asked to characterize relevant data for these patients.
Thirty-nine prevalent cases of AIDS were reported in ASPN from January 1982 through December 1987. Seventy-nine percent of the patients were male, 15 to 44 years of age; three patients (7.6%) were female; and all cases had at least one risk factor for AIDS. An expected number of cases for the 194,973 patients of 47 practices was calculated using age-sex register data and nationally based rates from 1986. The projected number, 13, corresponded with the number of AIDS cases, 11 and 15, reported from ASPN practices in 1986 and 1987, respectively.
This survey suggests that AIDS is at least as prevalent in the primary care practices in ASPN as predicted using national estimates, and may, in fact, be more prevalent. Primary care clinicians need to be prepared to assume a major role in addressing the AIDS epidemic.
尽管获得性免疫缺陷综合征（艾滋病）疫情十分严重，但对于初级保健医生患者群体中艾滋病的发病率和患病率却知之甚少。本研究旨在作为评估该疾病对初级保健实践影响的第一步。
我们开展了一项调查，以描述门诊哨点实践网络（ASPN）中的艾滋病病例特征。ASPN是一个基于实践的初级保健研究网络。1987年，它由65个诊所和193名临床医生组成，在美国和加拿大为约270,000名患者提供服务。要求每个诊所的临床医生报告其诊所在1982年1月至1987年12月期间照料的艾滋病患者数量。还要求他们描述这些患者的相关数据。
1982年1月至1987年12月期间，ASPN报告了39例艾滋病现患病例。79%的患者为15至44岁的男性；3例患者（7.6%）为女性；所有病例都至少有一个艾滋病危险因素。利用年龄-性别登记数据和1986年全国发病率，计算了47个诊所的194,973名患者的预期病例数。预计病例数为13例，分别与1986年和1987年ASPN诊所报告的11例和15例艾滋病病例数相符。
这项调查表明，艾滋病在ASPN的初级保健实践中的患病率至少与使用全国估计数预测的一样高，实际上可能更高。初级保健临床医生需要准备好在应对艾滋病疫情方面发挥主要作用。
