title: Sex, risk and responsibility: provider attitudes and beliefs predict HIV transmission risk prevention counseling in clinical care settings.
abstract: We examined factors associated with the frequency of HIV "prevention with positives" (PwP) counseling delivered by providers participating in demonstration projects at 26 clinics. Three hundred and fifteen primary care and support service providers completed a survey assessing the frequency of PwP delivered at initial medical care visits and at regular care visits. Providers reported delivering PwP counseling to more patients at initial visits (67%) than to those returning for regular care (53%; t = 11.8, p < 0.001). During initial and regular care visits, providers reporting a sense of responsibility for conducting PwP and those regularly discussing the risk of reinfection with patients reported significantly more frequent PwP counseling. Providers expressing a belief that no matter how much counseling was delivered, some HIV-infected patients would still infect others (prevention fatalism) reported significantly less frequent counseling at all visits. To improve the quality and quantity of HIV PwP counseling, providers training should address attitudinal barriers and facilitators to counseling and the importance of addressing risk routinely.
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, USA. janet.myers@ucsf.edu
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Myers
authors.forename: Carol Dawson
authors.initials: CD
authors.lastname: Rose
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Koester
authors.forename: Andre
authors.initials: A
authors.lastname: Maiorana
authors.forename: Faye
authors.initials: F
authors.lastname: Malitz
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Steward
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Morin
mesh_terms: D001291:Attitude of Health Personnel; D003376:Counseling; D003469:Culture; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012941:Social Responsibility