Role and contribution of private healthcare sector doctors in the management of HIV-infected patients in the eThekwini Metropolitan area of KwaZulu-Natal.

Abstract

Private healthcare sector doctors have a pivotal role to play in the management of HIV and AIDS infection. These doctors need to have an accurate knowledge of the management of the infection, and a positive attitude towards the treatment of persons with HIV and AIDS. This study investigated the extent of private healthcare sector doctor involvement in the management of HIV and AIDS patients and their training needs. Across sectional descriptive study of private general practitioners and specialists was undertaken in the eThekwini Metro of KwaZulu-Natal. Structured self-report questionnaires were sent to 931 private healthcare sector doctors. Of the 331 (35.6%) responses received, three doctors did not complete the questionnaire, 235 (71.6%) doctors managed HIV and AIDS patients, but 93 (28.4%) doctors did not; of these, 48 (51.61%) had not encountered HIV and AIDS patients, 25 (26.88%) referred such patients to specialists, six (6.45%) cited cost factors as reasons for not treating such patients, whilst 12 (12.90%) doctors, though they indicated that there were other reasons for not managing HIV-infected patients, did not specify the reason. Two doctors (2.15%) indicated that due to inadequate knowledge they did not manage HIV and AIDS patients. Most doctors, 151 (63.5%), managed between 1-20 patients, whilst 19 (8%) managed more than 200 patients. The mean number of years since doctors had qualified was 22.02 (SD 10.58). Significantly more younger (recently qualified) doctors than older (qualified more years) doctors treated HIV/AIDS patients (p<0.001). Most doctors (76.3%) expressed a need for more training/knowledge on the management of HIV patients in areas such as overall HIV care (59%), antiretroviral therapy (53%), side effect management (39%) and therapeutic monitoring (35%); 194 (62.2%) doctors indicated their willingness to participate in a post graduate diploma in HIV and AIDS management. These results suggest that increased private sector doctor involvement in the treatment of HIV/AIDS patients needs to be facilitated. Addressing doctors’ training needs could contribute to achieving this.