U.S. Doctors Not Providing Enough HIV Risk Reduction Counseling to HIV-Positive Patients, Study Says

Doctors in Atlanta, Baltimore, Los Angeles and Miami have not been providing enough risk-reduction counseling to HIV-positive patients, according to a study published in the July issue of the American Journal of Public Health, the AP/Las Vegas Sun reports. Dr. Carlos del Rio of Emory University and colleagues in a survey of 317 doctors found that 60% reported regularly providing risk-reduction counseling to newly diagnosed HIV-positive patients and 14% of doctors provided such counseling to existing HIV-positive patients. The researchers also found that doctors with patient loads of between one and 18 patients per month were nearly three times more likely to counsel new HIV patients than doctors with more than 100 patients per month. The researchers said that doctors may spend too much time emphasizing antiretroviral drug adherence, leaving little time to discuss HIV prevention, according to AP/Las Vegas Sun. Del Rio said that doctors need to shift away from the type of counseling conducted in the past that involved mainly end-of-life preparations and toward counseling patients on how to "live healthy with HIV, to prevent others from getting HIV and how to prevent yourself from getting another" sexually transmitted disease. Del Rio added that more education is needed to "incorporate HIV prevention to medical-care settings," and the federal government should reimburse doctors for counseling. The study was funded by CDC (Yee, AP/Las Vegas Sun, 7/28).