The role of the primary health care team in the care of people with HIV and AIDS

The model of health care for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is changing from a primarily hospital-orientated service to a more community-based pattern of care. Despite this, the role of the Primary Health Care Team (PHCT) in HIV and AIDS, care generally remains small. This study, in an area of high prevalence of HIV and AIDS, uses a combination of quantitative and qualitative methods to examine current PHCT involvement in the care of people with HIV and AIDS, attitudes to HIV and AIDS among PHCT members, and views of the PHCT and other key interest groups about future service development. Barriers to greater involvement of the PHCT in HIV and AIDS work are identified, including resources, attitudes, knowledge, and communication between specialist and generic service providers. These are discussed and possible ways of developing the PHCT's role are explored. We conclude that purchasers have a role to play in encouraging a shift of HIV and AIDS work from the secondary sector to the primary sector, both directly through the contracting process and also through an emerging role in facilitating co-operation between providers, which could be extended to enhancing relationships between specialist providers and general practitioners.