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Enhancing primary care HIV prevention: a comprehensive clinical intervention
W T Dodge1, J BlueSpruce, L Grothaus
1HIV/AIDS Program, Group Health Cooperative of Puget Sound, Seattle, Washington 98101-1776, USA. dodge.w@ghc.org
American Journal of Preventive Medicine
|March 29, 2001
Summary
A new intervention significantly improved patient recall of HIV/STD risk assessment and counseling, with sustained results over time. This approach enhanced provider discussions on sexual behaviors and risk reduction, especially for high-risk individuals.
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Disease (STD) risk assessment and counseling are crucial for public health.
- Despite recommendations, the rates of HIV/STD risk assessment and counseling provided by healthcare professionals remain low.
- There is a need for effective interventions to improve and sustain these essential preventive services.
Purpose of the Study:
- To implement and evaluate a comprehensive intervention designed to enhance and maintain HIV/STD risk assessment and counseling rates.
- To assess the impact of the intervention on provider-patient communication regarding sexual health and risk factors.
- To determine the sustainability of improved counseling rates over an extended follow-up period.
Main Methods:
- A one-group pre- and post-intervention design was employed, utilizing patient telephone surveys over a 62-week period.
- The study included 1042 patients from two outpatient health maintenance organization (HMO) clinics, encompassing symptomatic and routine visits.
- Surveys, conducted within three weeks of the index visit, measured patient recall of discussions on HIV/STDs, sexual behaviors, and risk reduction.
Main Results:
- The intervention significantly increased patient recall of providers discussing HIV/STD in general (OR 1.6), sexual behaviors/risk factors (OR 1.7), HIV prevention (OR 2.4), and personal risk reduction (OR 2.6).
- Provision of written HIV/STD materials also saw a significant increase (OR 2.8).
- Improvements were consistently observed across provider efforts, with the most substantial gains noted in high-risk patients, and results remained stable over 38 weeks.
Conclusions:
- A systematized, relatively non-intensive intervention can achieve sustained improvements in HIV/STD risk assessment and counseling within outpatient HMO settings.
- The findings suggest that such interventions are effective in enhancing provider communication and patient engagement in preventive health behaviors.
- This approach holds promise for improving sexual health outcomes in diverse patient populations.