PRIMARY-CARE PHYSICIANS AND THEIR HIV PREVENTION PRACTICES

A national random-sample survey of 4011 primary care physicians was co nducted to determine the extent to which they are providing HN prevent ion and clinical services, and to learn what characteristics and attit udes might impede the provision of such services. Physicians were aske d about their history-taking practices for new adult and adolescent pa tients, including asking about the use of illicit drugs (injection and noninjection), the number of sexual partners, use of condoms and cont raceptives, past episodes of sexually transmitted diseases (STDs), sex ual orientation, and sexual contact with partner(s) at high risk for H IV. A preliminary analysis was conducted and reported earlier by the C enters for Disease Control and Prevention (CDC), focusing on the HIV-p revention services being provided by primary care physicians.(3) This report provides additional analyses from this study, focusing on chara cteristics and attitudes that may prevent physicians from providing th ese services. Male physicians and the physicians' belief that patients would be offended if asked questions about their sex behaviors were s trongly predictive of not asking new patients about their sex and drug behaviors. The physician's specialty was also a strong predictor-OB/G YNs were predictive of asking these questions and GP/FPs were predicti ve of not asking the questions. Physicians who indicated that a majori ty of their patients were white were less likely to report asking pati ents about their sex and drug behaviors. The authors conclude that a s ubstantial number of primary care physicians are missing important opp ortunities to prevent HIV transmission by not adequately assessing pat ients' risks and not providing necessary risk-reduction counseling dur ing their physician-patient encounters. Physician's attitudes and beli efs about their patients, as well as their level of experience with HI V, may help to explain these observations.