STD/HIV prevention practices among primary care clinicians: risk assessment, prevention counseling, and testing.
OBJECTIVE
To describe current practices of primary care (PC) clinicians for STD/HIV control services: risk assessment, prevention counseling, and offering tests.


METHODS
We identified clinical strategies through qualitative interviews. We then surveyed by mail a random sample of Washington State family physicians, general internists, obstetrician-gynecologists, nurse practitioners, and certified nurse midwives. We identified characteristics of clinicians and their practices associated with each strategy and universal provision of each service.


RESULTS
We report on 519 clinicians (80% adjusted response rate). Clinicians provided services to selected patients they considered high risk. Universal practices were less common: risk assessment (56%), prevention counseling (60%), STD tests (30%), and HIV tests (19%). Universal services were more common among nurses, those recently trained, and those seeing more STD patients.


CONCLUSIONS
Different types of PC clinicians use widely differing clinical strategies and many use selective rather than universal approaches to STD/HIV control services. Further research is needed to develop tailored interventions to improve provision of these services.
Montaño
Daniel E
DE
Battelle Centers for Public Health Research and Evaluation, Seattle, Washington 98109-3598, USA. montano@battelle.org
Phillips
William R
WR
Kasprzyk
Danuta
D
Greek
April
A
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control*; D001291:Attitude of Health Personnel; D006801:Humans; D016015:Logistic Models; D009721:Nurse Midwives; D009722:Nurse Practitioners; D009774:Obstetrics; D010821:Physicians, Family; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011322:Primary Prevention; D018570:Risk Assessment; D012731:Sex Counseling / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014861:Washington