Private practice-hospital network for the management of HIV infected patients. An initial survey in the Val de Marne region]

A transmissible disease, necessitating medical, social and preventive management, AIDS implicates the involvement of diverse parts of the social and health care systems. The private health sector (general practitioners and specialists, nurses, physical therapists, dentists) must assure part of this management throughout the evolution of the disease. Discussions on how to handle the transference of the responsibility from the hospital to the private health sector have given rise to the network concept. Prior to establishing such a network, an inquiry was carried out to determine the practitioner's level of theoretical knowledge of AIDS and their involvement with infected patients. Mastery of theoretical elements varied, but better scores were obtained on questions dealing with diagnosis and treatment. As regards private practice (care, follow-up, prevention), responses indicated that, in the region around Créteil, experience was moderate, not exceeding 300 acts per year. Thirty doctors had more than a passing acquaintance with the disease and this activity had increased slightly from 1989 to 1990. As most patients were simultaneously followed by a staff physician, private practitioners preferred an annual update to long-term study leading to specialization. Thus the private sector, which is far from being saturated, has sufficient knowledge available and dispenses care ethically in agreement with institutional recommendations. The high number of responses (356 for 1,353 questionnaires) indicates the credibility of the inquiring organizations and the extreme sensitivity of the medical profession to AIDS.