AEGiS-15IAC: Practicing what you preach, retiring, and going public: Issues faced by HIV-infected doctors.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Practicing what you preach, retiring, and going public: Issues faced by HIV-infected doctors.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1019)

Klitzman R
Columbia U./NYSPI, New York, United States

BACKGROUND: HIV+ doctors (MDs) face many issues that have not be systematically studied, & can affect their treatment of HIV+ and other patients.

METHODS: We conducted 2 interviews of 2 hours each with MDs: 40 HIV+, & 25 w/ other diseases. Interviews were audiotaped & transcribed; & content-analysis has recently been completed.

RESULTS: Many HIV+ MDs found it hard to "practice what they preach" concerning adherence to treatment, safer sex, substance use & accessing mental health services. They became more aware of the difficulty of "sticking to a schedule", & became "less hard on patients": less likely to chastise or lecture them. They struggled with whether & how to "come out" &/or "go public". Desires arose to do so for educational or political reasons, but could backfire, as these MDs were not protected by the Americans With Disabilities Act. Questions arose of how to define & enact "going public"; & unexpected reactions could ensue. SomeMDs advised others not to do so. Others wanted to, but felt they couldn't. Fears of discrimination & peripheralization varied by geographic area & type of job, & some feared leaks of information & felt "stuck" in jobs. Disclosures to parents were hard among gay MDs who had tried to succeed professionally; & a few tried to suicide. Some felt burnt-out due to over-identifying with patients. They relied little on support groups; but tried to set limits professionally. Disclosure often forced retirement & vice versa. Some quit early to avoid patients' reactions; or contagion. Many missed work, but felt they could not return because of loss of disability. Some transitioned to research or administration, but clinical work was "all consuming". Others volunteered, which buffered self-esteem.

CONCLUSIONS: HIV+ MDs face many key issues (e.g., advising patients; burn out; retirement and going public) that are highly relevant for patients with HIV & other stigmatized disorders (e.g. genetic s). Difficulty practicing what they preach raises key questions of how to make prevention messages to patients more effective.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Physicians, Retirement, Homosexuality, Male, Public Sector, Safe Sex, Recognition (Psychology), Disclosure, Disabled Persons, Male, Humans, organization & administration

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