Evaluating interviewing techniques for the sexual practices history - Use of video trigger tapes to assess patient comfort

Background Although physicians recognize the importance of assessing a pati ent's risk for human immunodeficiency virus (HIV) infection, many are reluc tant to explore a person's sexual history, a principal determinant of this risk. Objective: To examine the feasibility of a research design that uses respon ses to viewing a videotaped interview as a proxy for how patients might fee l if they were interviewed using a specific approach, and to determine comf ort levels with a variety of interview approaches for conducting HIV risk a ssessment. Methods: Individuals responded to a videotape of several interviewing appro aches for HIV risk assessment. Responses to the following aspects were coll ected: introduction of HIV risk assessment, assessment of patient comfort w ith the topic, techniques for collecting HIV risk and sexual information, a nd exploration of sensitive issues not previously identified. Participants expressed levels of comfort by means of a Likert scale to rate their comfor t with each approach. Results: Participants expressed higher comfort levels with an introduction that used a ubiquity statement or lifestyle bridge question. Also; they exp ressed greater comfort when the interviewer addressed how they felt about r esponding to questions about their HIV risk. Participants reported highest levels of comfort with both patient-centered and closed-ended interviewing techniques. Women were less comfortable with an open-ended interviewing tec hnique. Conclusions: Individuals have different comfort levels for approaches used, to assess HIV risk. This trigger tape experimental design to assess comfort levels for interview techniques is feasible for exploring other aspects of physician-patient; communication; additional validation studies are recomm ended.