Human immunodeficiency virus and the primary care physician

As the scope and size of the human immunodeficiency virus (HIV) epidemic grows, the primary care physician will need to assume a greater role. A knowledge of HIV risk factors and the ability to perform pretest and posttest counseling for HIV testing is essential. Counseling patients on HIV risk reduction should be part of the HIV risk interview. An understanding of the benefits and contraindications of testing, as well as a respect for the impact of testing, is important. All HIV-seropositive individuals should undergo a complete history and review of symptoms as soon as test results are known. Judicious use of laboratory testing, including monitoring of CD4 cell counts, is recommended. Pneumocystis carinii prophylaxis and zidovudine therapy should be offered to patients with appropriately low CD4 counts.