HIV in primary care: an educational initiative for child health providers

Background With recent progress in controlling HIV disease in children, infected children are living longer than ever before. Their health care needs include health supervision services, such as developmental monitoring and anticipatory guidance, which are best provided by child health providers (Providers). Providers need to know about the care of children with HIV infection in order to provide optimal health supervision services.

Objective To design a curriculum to educate providers about the care of children with HIV infection, targeted to the needs of local providers.

Setting The primary care centre of an urban children's hospital in Connecticut during 1997–98.

Intervention We observed clinical cases; conducted a needs assessment, including discussions with providers and a review of educational resources; and held discussions with infectious disease subspecialists. From these, we designed a series of seminars covering individual topics generated mainly by providers. We then conducted a grand rounds lecture to cover the topics more broadly. All participants received a booklet covering the topics discussed.

Impact Providers received the sessions well. Self-reporting suggested changes in their care of children with HIV infection, including increased confidence in decision-making about routine health issues, more aggressive immunization, and better coordination of care with subspecialists. Many suggestions for further sessions were generated.

Conclusion An educational program tailored to the needs of local child health providers may be helpful in the care of their patients with HIV infection. This program can promote high-quality, co-ordinated care for the complex needs of these patients.