Medical student knowledge levels and performance in doing HIV risk assessment

The primary purpose of the study was to develop and evaluate a training program for medical students in sexual history-taking and HIV risk assessment. Sexual-history-taking performance was evaluated in the semester subsequent to the one in which the students received the instruction. An additional purpose of the study was to determine whether students, following participation in a sexual-history training program, would take a sexual history when course instructions did not explicitly direct her/him to do so but the patient presented with HIV risk factors. A final goal was to find out whether direct participation in, versus only observation of, sexual-history interviews would improve performance. Adequate performance on measurement on knowledge and skills was defined as above 75% correct on content examinations and satisfactory performance of the sexual history. Results showed that, when course instruction directed students to take a sexual history, performance was excellent. When students were not specifically directed to take a sexual history, but the patient had an HIV risk factor, performance was not as consistent. Following participation in the training program, student attitudes about the importance of taking a sexual history were very positive. Finally, when a student conducted a sexual-history interview him/herself, compared with viewing other students taking a history, he/she showed no significant improvement in examination performance.