Private Sector Involvement to enhance skills of physicians to manage HIV Cases – Andhra Pradesh Experience

Though private sector plays an important role in providing health care, in the case of HIV infected patients, a large number of physicians working in private medical institutions hesitate to provide care and support to them.

Andhra Pradesh AIDS Consortium (APAIDSCON), therefore, developed a four-day ‘Advanced Clinical Hands-on Training Program on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)’ to develop clinical skills among physicians in managing People Living with HIV (PLHIVs) including OIs and to treat PLHIVs without stigma and Discrimination.

A four day training program, developed after a scientific needs assessment, was organized to provide hands on experience for doctors working in hospitals attached to private medical colleges in the south Indian state of Andhra Pradesh. The trainees were introduced to the current concepts of HIV treatment, care and support protocols including ART management in a patient care setting in accordance with the national guidelines. They were encouraged to further their knowledge and skills in HIV patient care. About 60% of the learning was through bed side discussion and demonstrations, visits to the counseling and testing centre and interaction with the PLHIVs. The training was evaluated by post training test and follow up administration of pretest questionnaire 6 months later.

The post training mean score was significantly higher than the pre training score with about 70% showing improvement in all the topics. Follow-up assessment 6 months after training revealed that, before the training, 54% of the doctors had exhibited “right attitude” whereas after six months of training 74% of the trained doctors developed the “right attitude”. The percentage of clinicians treating HIV cases increased from none to 78%. The proportion of participants having “correct knowledge” on the appropriate regimens and treatment protocols also continued to be higher (48% vs. 66%).

The results clearly reveal that a training program that provided hands on experience enhancing the skills of physicians about HIV care, can increase the pool of physicians and increase access to patient care to PLHIV.