305261
Frequency and determinants of preventive care counseling by HIV medical care providers during encounters with newly diagnosed and established HIV patients
Methods: A probability sample of HMCP in 13 outpatient facilities in Houston/Harris County, Texas was surveyed between June and September, 2009. Composite indices were developed and used to evaluate preventive care counseling practices of participating providers. Data obtained were subjected to inferential statistics: chi-square test, bivariate and multivariate logistic regression analyses in relation to medical care and demographic characteristics of participants.
Results: Overall, HMCP offered more preventive care counseling to newly diagnosed patients than established patients (Adjusted Odds ratio (AOR)=7.28 (95% CI: 2.86-16.80)). HMCP were more likely to counsel newly diagnosed patients on medication and adherence (AOR=14.70; 95% CI: 1.24-24.94), HIV risk-reduction (AOR=5.91; 95% CI: 0.48-7.13), and disease screening (AOR=7.20; 95% CI: 0.72-11.81). HMCP who were less than 45 years of age, infectious disease specialists, and those who had less than 30 minutes of encounter time were less likely to counsel patients regardless of status. Participants who self-reported having sufficient time were three times more likely to counsel both types of patients.
Conclusions: Findings indicate the need for HMCP to step up preventive care counseling efforts, especially among established HIV patients. This will help patients build skills for adopting and maintaining safe behavior, thereby reducing the risk of onward transmission.
Learning Areas:
EpidemiologyProtection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Learning Objectives:
Assess the frequency of delivery of preventive care counseling by HIV medical care providers.
Identify the medical care and demographic characteristics associated with preventive care counseling in HIV medical settings.
Discuss the determinants of preventive care counseling practices for newly diagnosed and established HIV patients.
Keyword(s): Preventive Medicine, Practice-Based Research
Qualified on the content I am responsible for because: I am a senior Epidemiologist-Biostatistician at the Houston Department of Health and Human services (HDHHS) and project coordinator of a CDC-funded HIV/AIDS special surveillance project in Houston/Harris County, Texas. Collectively, I have more than 23 years of extensive experience in teaching, research, community development and projects management that span academic and research institutions, and international organizations through public health agencies. I am a visiting Scientist at the Institute of Community Health, UH college of Pharmacy.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.