Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, January 21, 1994 TAG: 9401210080
SECTION: NATIONAL/INTERNATIONAL PAGE: A3 EDITION: METRO
SOURCE: The Washington Post
DATELINE: WASHINGTON LENGTH: Medium
The agency published a 196-page "clinical practice guideline" on how to diagnose and manage patients in the early stages of infection with the human immunodeficiency virus.
"Some providers are reluctant [to treat HIV patients] for a variety of reasons," Philip R. Lee, director of the Public Health Service, said at a news conference. Some of that reluctance comes from fear and prejudice, though most, he said, comes from the belief by many doctors that HIV infection is too complicated for anyone but experts to manage.
"By having the knowledge base in one place, at their fingertips, I think we'll overcome the major obstacle," Lee said.
The guideline is the seventh in a series of Public Health Service pamphlets aimed at improving treatment of common medical problems. As with the others, the one for HIV infection stresses the importance of primary care practitioners, not specialists, in making the diagnosis and providing routine treatment of the illness.
The document functions not only as a "how-to" manual for strictly medical questions, but also discusses issues such as the risks and benefits of revealing one's HIV status to others; the importance of including women and minority groups in AIDS drug experiments; and some of the particular problems of access to care encountered by poor people infected with the virus.
The guideline addresses the needs not only of adult men - the original and largest infected population - but also women, adolescents, children and infants.
About 1 million Americans are infected with HIV. This year, between 40,000 and 60,000 new infections are expected to occur.
"In too many communities, people have been undiagnosed, misdiagnosed or ignored after diagnosis . . . by providers who are ignorant of how to treat or unwilling to treat," said Cornelius A. Baker, a representative of the National Association of People with AIDS. The guideline "is an extremely useful tool in demystifying treatment . . . especially in those providers who are seeing their first case of confirmed HIV infection."
Though the guidelines acknowledge that people with advanced AIDS may need specialty care, they stress that treatment of relatively stable HIV infection falls well within a generalist's realm.
A 36-page "Quick Reference Guide for Clinicians," which includes recommendations and treatment "decision trees," and a 17-page "Consumer Guide" to early HIV infection also were released Thursday.
Copies of the documents will be sent to hospitals, clinics, medical societies and any person who requests one.
Persons wanting an English-language copy can call (800) 342-AIDS, and those wanting a Spanish-language version can call (800) 344-SIDA. Deaf access is (800) AIDS-TTY.
by CNB