title: Translating concern into action: HIV care providers' views on counseling patients about HIV prevention in the clinical setting.
abstract: Recent Centers for Disease Control (CDC) guidelines recommend that HIV care practitioners provide HIV prevention counseling to patients at routine medical visits. However, research shows that HIV care practitioners provide such counseling infrequently, presenting a challenge for clinics implementing these guidelines. Our qualitative study of 19 HIV care providers at an infectious diseases clinic in the southeastern US explored providers' beliefs about their patients' HIV transmission behaviors, expected outcomes of conducting HIV prevention counseling, and perceived barriers and facilitators to counseling. Providers' concern about HIV transmission among their patients was high but did not "translate into action" in the form of counseling. They anticipated poor outcomes from counseling, including harm to patient-provider relationships, and failure of patients to change their behavior. They also listed barriers and facilitators to counseling, most importantly time, state reporting policies, and conversational triggers. Implications for implementation of CDC guidelines and clinic-based "Prevention with Positives" programs are discussed.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Grodensky
authors.forename: Carol E
authors.initials: CE
authors.lastname: Golin
authors.forename: Maureen S
authors.initials: MS
authors.lastname: Boland
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Patel
authors.forename: E Byrd
authors.initials: EB
authors.lastname: Quinlivan
authors.forename: Matt
authors.initials: M
authors.lastname: Price
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003376:Counseling; D004777:Environment; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000628:therapy* / Q000635:transmission; D006282:Health Personnel; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000458:organization & administration*; D016312:Treatment Refusal / Q000706:statistics & numerical data