'HIV Specialists': The Time Has Come

THE PLACE OF acquired immunodeficiency syndrome (AIDS) in the structure of medical care delivery is still evolving. One important consideration is whether the care of persons infected with the human immunodeficiency virus (HIV) should be part of general practice or specialty care. Like many specialists (physicians with advanced training and/or certification in an area of medicine), physicians who care for patients infected with HIV face a spectrum of conditions that are rare, complicated, difficult to manage, and require familiarity with a rapidly expanding medical knowledge base. Still, commentary has emphasized that "AIDS is a primary care disease," citing the need to destigmatize patients, improve disease recognition and prevention, and forestall any shortage of appropriately trained specialists as HIV infection becomes more prevalent nationwidw.¹⁻³"Because patients with AIDS can be cared for effectively by primary care physicians," maintains one policy statement, "they [the physicians] should acquire the necessary skills and