Our objectives were to (1) assess primary care physicians' performance
at screening patients for HIV risks using patient report; (2) compare
patient recall concerning screening with physician report; and (3) co
mpare HIV risk screening with general preventive health screening. Up
to 20 patients from 126 physicians' practices anonymously completed 1,
820 questionnaires. Questionnaires assessed screening from physicians
about HIV risks and general preventive health care. Two scales were de
veloped to measure comprehensiveness of screening. Based on patient re
call, physicians performed poorly in HIV risk screening. On an HN risk
-screening scale, patients were screened concerning 11% of items asses
sed. In comparison, patients recalled screening concerning 75% of gene
ral prevention items assessed. Patients with acknowledged HIV risk fac
tors and younger patients were screened more for HIV risk, but many pa
tients with risks were still missed. Physicians' estimates of their sc
reening were relatively concordant with patient report in general prev
ention areas but were discordant with patient recall of HIV risk scree
ning; physicians estimated considerably more screening than their pati
ents recalled. Female physicians performed better than male physicians
in both HIV risk screening and general preventive health screening; p
hysicians with more HIV experience performed better at HIV risk screen
ing. HIV risk screening in the primary care setting remains inadequate
. Comparable attention to that given to general prevention by primary
care physicians is needed in screening patients for HIV risk behaviors
.