Marseille 2007
| Abstract #76 - Its really a myriad of different signals, not just the textbook: The challenges of diagnosing and managing the depression of HIV-positive gay men in general practice | ||||
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Session: 6.36: Posters A (Poster) on Monday in Chaired by Authors: Presenting Author: Dr Henrike Korner - University of New South Wales, Australia |
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| Additional Authors: Dr Christy Newman, Dr Limin Mao, Prof Susan Kippax, Prof Michael Kidd, Prof Deborah Saltman, | ||||
| Aim: The Primary Health Care Project on HIV and Depression is a unique collaboration between social researchers, general practice researchers, general practitioners and community partners. Its aims are to: describe, measure and compare depression among HIV-positive and HIV-negative gay men and HIV-negative heterosexual men, and identify factors associated with depression in these three groups; describe the ways in which depression is managed by GPs and the men themselves, especially those with HIV; develop the research capacity and skills of GPs to assess and manage depression, especially among people with HIV. This paper describes the ways in which GPs with high caseloads of gay men, especially HIV-positive gay men, diagnose and manage depression in general practice. | ||||
| Method / Issue: Semi-structured, in-depth interviews were conducted with GPs with high caseloads of gay men and HIV-positive gay men in three locations: Sydney, Adelaide and a rural coastal town. Interviews explored the ways in which GPs approached the diagnosis, treatment and management of depression, the particular challenges of managing depression alongside HIV, issues of depression related to gender and sexuality, and GPs use of mental health professionals, service and other resources. Analysis involved the identification of recurrent themes, including practices, experiences and attitudes. | ||||
| Results / Comments: Preliminary results indicate that GPs consider depression to be an integral part of HIV primary care. Because of the long-term nature of the doctor-patient relationship, particularly in the case of HIV-positive patients, GPs are highly sensitized to changes in patients emotional states and other signs of depression in their patients and take a proactive approach to inquiring about depression in their patients. Early diagnosis and enhanced management of depression in HIV-positive patients is an outcome of the social dynamics afforded by the ongoing, long-term nature of this doctor-patient relationship. | ||||
| Discussion: In-depth qualitative interviews provide a nuanced description of the ways in which GPs approach the diagnosis and management of depression in gay men with and without HIV. They also highlight the specific challenges of diagnosing and managing depression in the context of an individuals HIV infection and the broader context of the HIV epidemic. The findings from the project will inform the development of a training package and workshops for GPs who prescribe antiretrovirals. | ||||
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