Talking about AIDS

Despite increased public and professional awareness, patients and physician s tend to avoid discussions about HIV. Empiric studies of patient-physician communication point to specific common communication breakdowns. These inc lude lack of a good opening line, inappropriate context, awkward moments, v ague language, and a physician-centered rather than a patient-centered inte rview style. In effective HIV-related discussions, clinicians elicit the pa tient's beliefs and concerns first, are organized, use empathy, provide a r ationale for the discussion, persist through awkward moments, and clarify v ague language. In addition to information about sexual behaviors and the nu mber, gender, and HIV status of partners, clinicians should ask about the c ontext and antecedents to risk behaviors, praise prior attempts to reduce r isk, and assess the patient's motivation to change. Although studies indica te that experienced practitioners often do not have these skills, they can be learned.