Researchers Study Prevention for HIVers

Prevention for positives is one of the major HIV initiatives that CDC announced in April to try to reduce the number of new HIV infections. Research presented at the recent 2003 National HIV Prevention Conference in Atlanta documented "considerable missed opportunities" to discuss prevention issues when HIV-positive patients visited physicians at public clinics.

University of California-San Francisco researcher Stephen Morin described the results of interviews conducted with 618 patients immediately after they had seen their physician at 16 Ryan White-funded public health clinics in nine states. More than two-thirds of the patients were sexually active, and 20 percent of those were concerned about potentially having infected others. About a quarter of total participants said that at their last visit, someone at the clinic spoke with them about safer sex. However, "only 6 percent indicated that they had any discussion of specific sexual activities," usually occurring at the initial visit instead of later in treatment.

In response to an increase of STDs among gay HIV patients, Denver public health physician Mark Thrun and colleagues introduced a risk-assessment guide, or checklist, as part of their primary care sessions with patients. It should be used annually with each patient, Thrun said. The best way to get doctors on board seems to be to link prevention to the risk of reinfection and the compounded difficulties of treating such patients.

"Gay men don't use terminology such as receptive anal intercourse. [Heterosexual] providers weren't even aware what 'top' and 'bottom' meant," Thrun said. In response, he created a training program to cover such areas.

Deborah Parham, the federal Ryan White administrator, said that beginning in the fall, they will fund 15 demonstration projects to identify a variety of approaches that might be used in physicians' offices to implement prevention for positives. If they prove successful, Parham intimated that Ryan White programs might authorize funding to cover such activities as a normal part of care.

Back to other news for August 27, 2003