Individuals with HIV/AIDS are living longer, but their needs as they age is revealing a gap in care that has led some to call for a specialized training track for medical residents.
“HIV management is included in many residency training programs, but there is no particular emphasis on it in most. It competes with other important training content,” Howard Libman, MD, director of the HIV Program at Healthcare Associates at Beth Israel Deaconess Medical Center and professor emeritus of medicine at Harvard Medical School told Medical Economics.
Libman and several colleagues decided to tackle the problem by creating an HIV-specific primary care track for internal medicine residents and to publish their findings. The research, published in the Journal of General Internal Medicine, revealed that there might be an opportunity somewhere between primary care and specialized medicine for a new way to train residents.
Mortality rates among individuals infected with HIV are falling, although there are still an estimated 50,000 new cases each year in addition to the 1.2 million individuals already living with the virus in the United States. The problem, according to the report, is that first-generation clinicians specializing in HIV are retiring, and applications to infectious disease fellowships are also dropping, raising concerns about a shortage of qualified practitioners to care for HIV-infected patients in the future. While primary care physicians are “well positioned” to manage the needs of patients with HIV, the paper notes that there are sometimes unique challenges in this population that require additional training.
“People living with HIV have better outcomes when cared for by practitioners with more experience managing their complex needs,” the paper notes.
The study goes on to state that general physicians who manage smaller numbers of patients with HIV “performed significantly worse on HIV-related quality measures, including engagement in care, viral load testing, and virologic suppression,” and that internal medical residents often lack the time to develop the continuity of care that these patients really need.