HIV risk assessment practices of primary care physicians: Results from a national survey

Background: Numerous Federal agencies and professional societies have recommended that physicians assess their patients' risk for HIV infection. It has been more than a decade; however, since any reports on physician risk assessment practices have been published. The purpose of this study was to close that information gap. Methods: A survey was mailed to a national, random sample of 1400 practicing primary care (i.e., family practice, internal medicine, pediatric medicine and obstetrician-gynecologist) physicians. Results: Among the 649 physicians who returned completed questionnaires (49% of those receiving surveys), 498 met our inclusion criteria. A majority of respondents reported they did not ask patients “often” or “always” about six of the eight risk practices under study. Physicians were most likely to ask about STD history (57%) and least likely to ask about specific sexual practices (12%). The mean HIV risk assessment compliance among physicians ranged from “rarely” to “sometimes” regardless of the risk practice in question. Conclusion: Primary care physicians are not following recommended practice guidelines for HIV risk assessment. This suggests that they are missing opportunities to test and counsel patients, and reduce disease transmission.