Doctors in Atlanta, Baltimore, Los Angeles, and Miami were more likely to provide HIV risk-reduction counseling to newly diagnosed HIV patients than current HIV patients, researchers reported Tuesday in a Centers for Disease Control and Prevention-funded study. While 60% of 317 doctors surveyed say they regularly provide counseling to new HIV patients, only 14% say they routinely counsel patients already infected.
Drug treatments have changed HIV counseling from its concern with dying. "Now patients are having normal lives, and having sex is a part of having a normal life," says Carlos del Rio, an Emory University professor of medicine and a study author. "The counseling we have to do is how to live healthy with HIV to prevent others from getting HIV and how to prevent yourself from getting another sexually transmitted disease." Medical evidence shows that doctors' talking to HIV patients about the disease can help prevent its spread, Del Rio says.
Time is a factor: Those with small patient loads (1-18 patients a month) were nearly three times more likely as doctors with high patient loads (more than 100 patients a month) to counsel new HIV patients. Doctors with medium patient loads (19-100 patients a month) were nearly twice as likely to counsel HIV patients than high-volume doctors.
HIV specialists are probably an underused resource in health officials' HIV prevention strategy, says the study. In addition, doctors might spend too much time emphasizing adherence issues to have an opportunity to discuss how not to infect others. Federal agencies should reimburse doctors for counseling, Del Rio says.
The full study, titled "Delivery of HIV Prevention Counseling by Physicians at HIV Medical Care Settings in Four U.S. Cities," appears in the July issue of the American Journal of Public Health. (AP)