Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2017 07 06() doi 10.4158/EP171816.OR
Objective With advances in the treatment of HIV infections, the life expectancy of people living with HIV (PWH) is fast approaching that of the general population. Endocrine and metabolic disorders occur more frequently in PWH than in the general population. This study assesses the knowledge, practice patterns and confidence levels among endocrinology trainees in Singapore in managing endocrine disorders in PWH. Methods An anonymous 31-item survey was administered to 23 endocrinology trainees. Four domains were assessed: (1) Previous exposure to endocrine disorders in PWH; (2) Attitudes towards treating PWH; (3) Case studies in endocrinology designed to assess for differences in treatment philosophy between a PWH and a non-infected counterpart; and (4) Confidence in managing endocrine disorders in PWH. Results The participation rate was 73.9%, with the majority of trainees (88.2%) having managed fewer than 5 PWH with endocrine disorders. 94.1% of the trainees had little or no hesitation in treating PWH, but more than half (58.8%) felt inadequate in confidently managing them. 82.4% deemed HIV Endocrinology as an emerging field and were open to the idea of pursuing it as a subspecialty in the future. Reassuringly, most trainees would not compromise medical treatment for a PWH if it were indicated. More than half were ambivalent about prescribing cross-hormonal therapy to transgender individuals. Conclusion Endocrinology trainees feel that while HIV Endocrinology is an emerging field, they lack exposure, training and confidence in the management of these patients. Although they would treat medical conditions well, they lacked knowledge in hormonal treatment of transgender individuals.