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According to consensus guidelines, clinicians should provide a brief sexual risk behavioral intervention in each visit as part of HIV care. Studies based on participant reports suggest this is occurring infrequently; however, studies based on direct observation of clinical encounters are lacking.In the current research, the team conducted a mixed method study based on audio recordings of 116 routine outpatient visits by 58 different HIV patients in five practice sites. After coding, the visit transcripts were analyzed using a quantitative system. A qualitative analysis was conducted for the dialogue segments in which sexual risk behaviors were discussed.
Ten visits included communication about sexual risk behavior; these discussions were “generally quite brief,” the authors reported. In two visits, “substantial counseling” regarding sexual risk reduction occurred, while two others included substantial discussion that “was not evidently directed at the patient’s changing behavior.” In seven additional visits, physicians did not follow up on cues that suggested “a need or opportunity for such discussion.”
“Interactions about sexual risk had less patient engagement than interactions about other health behaviors,” the authors concluded. “Physicians seldom provide sexual risk reduction counseling in HIV care, even where specific indications are present.”
The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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