HIV Medical Association Unveils New Guidelines for HIV/AIDS Specialists
The HIV Medicine Association has released new guidelines outlining qualifications physicians should meet to be considered HIV/AIDS specialists. According to the guidelines, HIV/AIDS specialists should have managed at least 25 HIV-infected patients within the past year and have performed a minimum of 15 hours of "HIV-specific continuing medical education," including a minimum of five hours related to antiretroviral therapy. However, these standards allow for flexibility based on factors such as the prevalence of HIV in an area, the availability of physicians to treat HIV patients and any existing state laws or other institutional guidelines related to CME. "Recently trained" infectious diseases specialists could also be considered "qualified providers" for HIV/AIDS patients, although the "rapid pace" of changes in HIV medicine mean that such specialists may not "remain an expert in HIV disease over time." The HIVMA guidelines are meant to help "ensur[e] that patients with HIV disease receive the highest quality of care that reflects the most current medical research at the hands of those who have demonstrated experience and commitment to treating this disease" (HIVMA guidelines, 3/2). Dr. William Powderly, chair of HIVMA, said, "HIVMA believes that a new certification examination process for HIV-qualified physicians is unnecessary. Rather, the association proposes that any credentials process to identify HIV-qualified physicians be based on a combination of patient experience and the demonstration of ongoing education and training in HIV care, particularly in the area of antiretroviral therapy" (HIVMA release, 2/22). A copy of the new guidelines is available on the HIVMA Web site at http://www.hivma.org/HIV/HIVMA/HIVProviderDef.htm.
The new guidelines will help to clarify certain aspects of state laws, such as California's, which classify HIV/AIDS as a disease that "requires specialized medical care" (AB 2168 text, 3/2). Last September, California passed a law requiring HMOs to "ensure that patients with HIV or AIDS receive referrals to doctors who specialize in treating the disease" (Kaiser Daily HIV/AIDS Report, 9/18). By ensuring that individuals with HIV or AIDS have the right to be treated by a physician specializing in the field, the law aims to "maximize the access of an enrollee with HIV or AIDS to a provider with demonstrated expertise in treating a condition or disease involving a complicated treatment regimen that requires ongoing monitoring of the patient's adherence to the regimen" (AB 2168 text, 3/2).