Care for patients with HIV infection and AIDS.

Patients with the acquired immune deficiency syndrome (AIDS) present only a few of the clinical problems that must be dealt with and it is important to consider all of those with human immunodeficiency virus (HIV) infection as well as those with AIDS. There are 730 patients with AIDS but up to 60000 people infected with HIV in the United Kingdom. Many of the people with HIV infection are well asymptomatic and unaware that they are infected but others who have not yet developed AIDS have physical psychological social and occupational problems that require as much care as in the case of patients with AIDS. This article discusses the effect of HIV and AIDS on the hospital service and raises some epidemiological and general questions that need to be answered to plan services and then review different approaches that might be used to provide care in the community. There are many ways to look after patients with varying degrees of HIV infection and AIDS. This should allow a series of models to be developed and evaluated. Different models of terminal care might also be assessed. Such evaluation would require different parameters that incorporate clinical outcome and an examination of the patients attitudes and those of their families general practitioners domiciliary nurses and home help staff. Finally the social and economic costs of different kinds of care need to be studied to help in finding the most efficacious acceptable and cheapest form of care.