Making decisions about therapies

January 2007     View PDF     En español

Choosing a doctor

Finding a doctor who has experience treating people living with HIV is very important. Studies have shown that people with HIV who see doctors experienced in treating people with HIV are more likely to be long-term survivors than those with inexperienced doctors.

According to these studies, an HIV-experienced doctor is someone who has five or more people in their practice who are living with HIV, though in general, the more experience and patients the physician has, the better. Consider five a minimum. Experienced doctors will usually have more skill in prescribing and monitoring anti-HIV drugs wisely, and are also more likely to wisely prescribed preventative therapies. Because women face unique gynecological and pregnancy concerns, choosing an experienced gynecologist and/or obstetrician is also important.

In some cases, choosing a highly HIV-experienced doctor is not possible. This is especially true in rural settings where HIV-positive people may be more isolated than in major cities. This does not mean that one need receive less than optimal care.

Even in the most rural settings, there is usually at least one healthcare provider who has worked with HIV-positive people. Some experience is better than none. However, it may mean that the patient and doctor need to be more diligent in learning about HIV, keeping up to date on the latest in treatment information and finding appropriate resources. Developing an open and comfortable relationship will help this ongoing process.

Often, people living with HIV in such situations play an important role in keeping their doctors up to date by bringing them new information, reports from medical conferences and resources available from groups like Project Inform. While physicians may sometimes at first be inclined to reject information from anyone other than doctors, they often get over this prejudice when they realize that, at least in HIV disease, community groups and resources often have better access to information, and more time for reviewing it, than they do. Many physicians come to welcome the input their patients can bring them.

Finally, the general principal of choosing an HIV-experienced doctor applies to practitioners of alternative systems of healing as well, like traditional Chinese medicine, herbalists, acupuncturists and other holistic healers. If you have an interest in complimentary or alternative therapies, the healthcare provider should have experience in their use in HIV-positive people, not just experience with therapies themselves.

Some herbs and supplements, for example, can affect the way commonly used anti-HIV drugs are absorbed in the body, so knowledge of both types of therapy is critical. A doctor or healing practitioner who keeps up to date on literature about new discoveries in our understanding of HIV disease and who has experience treating people living with HIV is an important partner in your healthcare.