ARE MEDICAL-STUDENTS READY TO PROVIDE HIV-PREVENTION COUNSELING

Purpose. To determine whether medical students were prepared to assess risk and counsel patients about prevention of HIV infection, and whet her HIV-related experience produced better knowledge and counseling sk ills. Method. In 1995, students at four North Carolina medical schools interviewed a standardized patient portraying a young woman concerned about: HIV infection, The standardized patient recorded whether stude nts asked risk-behavior questions and provided risk-reduction advice. A 21-item questionnaire assessed the students' knowledge of HIV testin g and prevention. Students indicated whether they had had experience i n educational settings related to HIV or STDs. Results. 415 students c ompleted both the patient interview and the questionnaire. Many failed to ask the patient about several HIV-risk behaviors. Although nearly all (98%) inquired about condom use, fewer than two thirds asked about the patient's history of STDs, number of sexual partners, or specific sexual practices. Most students advised the patient to use condoms. T he average score on the knowledge test was 79%; 70% of students confus ed anonymous with confidential testing, more than half overestimated t he risk of HIV transmission from a needle stick, and nearly one in ten did not know how to use a condom. Educational exposures did not produ ce significantly better risk assessment, counseling information, or kn owledge scores. Conclusion. A majority of experienced medical students did not assess several important risk factors uf a patient concerned about HIV infection, and many would have provided incorrect informatio n related to HIV testing and prevention of infection. Patient contact in traditional clinical settings did nut: influence prevention knowled ge or behavior. More innovative methods are needed to train students i n HIV-infection prevention and counseling.