Newman Christy E, Kidd Michael R, Kippax Susan C, Reynolds Robert H, Canavan Peter G, de Wit John B F
National Centre in HIV Social Research, The University of New South Wales, Sydney, NSW 2052, Australia.
Sex Health. 2013 Jul;10(3):193-8. doi: 10.1071/SH12157.
The science of HIV prevention and treatment is evolving rapidly, resulting in renewed calls to increase rates of HIV testing and, in particular, facilitate the timely and possibly earlier initiation of treatment, as this has the potential to dramatically reduce new infections. Little is known about how to engage non HIV specialist Australian general practitioners (GPs) with these new priorities.
Content related to the engagement of non HIV specialist GPs in the HIV response was identified within the transcripts of in-depth interviews with policy key informants (n=24) and general practice clinicians (n=47) engaged with HIV medicine. A qualitative analysis of the semantic meaning of this content identified three categories of 'issues' described by participants.
Educational issues referred to a lack of attention to HIV in medical curricula, a perception that HIV care is only provided by HIV-specialist GPs, a need to make HIV testing more 'routine' in GP education and a need to strengthen GP awareness of referral options. Organisational issues encompassed time pressures in general practice, and a need for general practice nurses and for rapid testing to become available, as well as formalised peer mentoring and comanagement opportunities. Societal issues included the changing dynamics of HIV transmission and a need to reconnect GPs with the Australian HIV response.
To successfully engage non HIV specialist GPs in the promotion of regular HIV testing and timely initiation of treatment, challenging issues affecting their capacity and willingness must be urgently addressed.
艾滋病毒预防和治疗科学正在迅速发展，这使得人们再次呼吁提高艾滋病毒检测率，特别是促进及时甚至更早开始治疗，因为这有可能大幅减少新感染病例。对于如何让澳大利亚非艾滋病毒专科的全科医生（GP）参与这些新的优先事项，人们知之甚少。
在对参与艾滋病毒治疗的政策关键信息提供者（n = 24）和全科临床医生（n = 47）进行深入访谈的记录中，确定了与非艾滋病毒专科全科医生参与艾滋病毒应对相关的内容。对这些内容的语义进行定性分析，确定了参与者描述的三类“问题”。
教育问题包括医学课程中对艾滋病毒缺乏关注、认为艾滋病毒护理仅由艾滋病毒专科全科医生提供、需要在全科医生教育中使艾滋病毒检测更“常规化”以及需要加强全科医生对转诊选择方案的认识。组织问题包括全科医疗中的时间压力，以及需要有全科护士和快速检测服务，还有正式的同伴指导和共同管理机会。社会问题包括艾滋病毒传播动态的变化以及需要让全科医生重新参与澳大利亚的艾滋病毒应对工作。
为了成功让非艾滋病毒专科全科医生参与促进定期艾滋病毒检测和及时开始治疗，必须紧急解决影响他们能力和意愿的具有挑战性的问题。
