pediatrician in a typical week are 2 or under, while only 17% of the cases are adolescents (ages 12–21). No data are available to indicate what percentage of pediatricians are conducting HIV counseling and testing or what percentage of the cases seen are HIV-positive. 10

The AAP has issued several statements to its members that follow the lead of the PHS guidelines: (1) The Role of Pediatricians in Prevention and Intervention (1993); (2) Perinatal Human Immunodeficiency Virus Testing (1996); (3) Evaluation and Medical Treatment of the HIV-Exposed Infant (1997); and (4) a joint statement with ACOG on testing for HIV (1997).

Family Practice Practitioners11

There are more than 84,000 practicing family physicians, family practice residents, and medical students with an interest in family practice. Family physicians (FPs) and general practitioners (GPs) are responsible for more outpatient medical visits than any other specialty and place a high priority on preventive health services. More than 30% provide obstetrical care in their practice and more than 90% provide pediatric care. The National Ambulatory Medical Care Survey of 1993 revealed that 0.12% of all office visit conditions in family practice were for HIV; counseling in HIV transmission was given in 0.54% of visits by GPs-FPs; HIV testing was included in 0.13% of visits.

The American Academy of Family Physicians has adopted as its policy the section "Guidelines for Counseling and Testing for HIV Antibody" from the CDC's (1987) PHS guidelines. The academy recommends universal HIV counseling and voluntary testing for all pregnant women and supports the enactment of state laws providing for reporting HIV.

Nurse Midwives12

There are more than 5,000 nurse midwives in clinical practice in the country and more than half are employed in a hospital or physician practice. Nurse-midwifery practice is legal in all 50 states and the District of Columbia. Certified nurse midwives (CNMs) are educated in nursing and midwifery and provide primary care to women of childbearing age, including prenatal, labor, and delivery care, postpartum care; gynecological exams; newborn care; assistance with family planning decisions; preconception care; menopausal management; and counseling in health maintenance and disease prevention.

Nurse midwives attended more than 205,000 births in the United States in

10  

Data provided by the AAP.

11  

Information provided by the American Academy of Family Physicians.

12  

Information in this section provided by the American College of Nurse Midwives, Washington, DC.



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