Patient report of HIV risk screening by primary care physicians

Our objectives were to (1) assess primary care physicians' performance at screening patients for HIV risks using patient report; (2) compare patient recall concerning screening with physician report; and (3) compare HIV risk screening with general preventive health screening. Up to 20 patients from 126 physicians' practices anonymously completed 1,820 questionnaires. Questionnaires assessed screening from physicians about HIV risks and general preventive health care. Two scales were developed to measure comprehensiveness of screening. Based on patient recall, physicians performed poorly in HIV risk screening. On an HIV risk-screening scale, patients were screened concerning 11% of items assessed. In comparison, patients recalled screening concerning 75% of general prevention items assessed. Patients with acknowledged HIV risk factors and younger patients were screened more for HIV risk, but many patients with risks were still missed. Physicians' estimates of their screening were relatively concordant with patient report in general prevention areas but were discordant with patient recall of HIV risk screening; physicians estimated considerably more screening than their patients recalled. Female physicians performed better than male physicians in both HIV risk screening and general preventive health screening; physicians with more HIV experience performed better at HIV risk screening. HIV risk screening in the primary care setting remains inadequate. Comparable attention to that given to general prevention by primary care physicians is needed in screening patients for HIV risk behaviors.