Commitment, value conflicts and role strains among French GPs in care for HIV positive patients

Abstract

A survey was carried out on a random sample of GPs in the city of Marseille. 18.5% had been involved during the past year in a regular follow-up of HIV patients. They were in charge with 79.8% of all ambulatory care of HIV + patients. Those informally 'specialized' professionals were connected to health networks (not only hospital structures but also associations dealing with commitment in care). Socio-biographical factors, training and environmental opportunities and ideological orientations would positively relate with commitment in care. GPs who were not involved with care, would worry more about personal risk of contamination; would not believe that wearing gloves could be a sufficient protection when doing invasive procedures; would feel less at ease with HIV patients, would be more strongly in favor of coercive measures with IVDU's. Most GP's would agree to avoid drug users HIV + patients. They would attribute to them more guilt and responsibility than to other patients. Uncertainty concerning relevant knowledge, negative attitudes towards some patients like IVDU's and anticipated difficulties to deal with ethical and relational dilemmas keep limiting GPs interest and positive motivation in care for HIV patients.