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July 2004, Vol 94, No. 7 | American Journal of Public Health 1186-1192
© 2004 American Public Health Association


RESEARCH AND PRACTICE

Delivery of HIV Prevention Counseling by Physicians at HIV Medical Care Settings in 4 US Cities

Lisa R. Metsch, PhD, Margaret Pereyra, DrPH, Carlos del Rio, MD, Lytt Gardner, PhD, Wayne A. Duffus, MD, PhD, Gordon Dickinson, MD, Peter Kerndt, MD, Pamela Anderson-Mahoney, PhD, Steffanie A. Strathdee, PhD and Alan E. Greenberg, MD for the Antiretroviral Treatment and Access Study Group

Lisa R. Metsch and Margaret Pereyra are with the Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, Fla. Carlos del Rio is with the Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Ga. Lytt Gardner and Alan E. Greenberg are with the Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta. At the time of the study, Wayne A. Duffus was with the Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine. Gordon Dickinson is with the Department of Medicine, University of Miami School of Medicine. Peter Kerndt and Pamela Anderson-Mahoney are with Health Research Association, Los Angeles, Calif. At the time of the study, Steffanie A. Strathdee was with the Johns Hopkins School of Hygiene and Public Health, Baltimore, Md.

Correspondence: Requests for reprints should be sent to Lisa R. Metsch, PhD, Department of Epidemiology and Public Health, University of Miami School of Medicine, 1801 NW 9th Ave, Suite 330a, Miami, FL 33136 (e-mail: lmetsch{at}med.miami.edu).

Objectives. We investigated physicians’ delivery of HIV prevention counseling to newly diagnosed and established HIV-positive patients.

Methods. A questionnaire was developed and mailed to 417 HIV physicians in 4 US cities.

Results. Overall, rates of counseling on the part of physicians were low. Physicians reported counseling newly diagnosed patients more than established patients. Factors associated with increased counseling included having sufficient time with patients and familiarity with treatment guidelines. Physicians who perceived their patients to have mental health and substance abuse problems, who served more male patients, and who were infectious disease specialists were less likely to counsel patients.

Conclusions. Intervention strategies with physicians should be developed to overcome barriers to providing counseling to HIV-positive patients.




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[Abstract] [PDF]




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