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APHA Scientific Session and Event Listing

Shilpa N. Patel, MPH¹, Carol E. Golin, MD, MPH², Tsui-Shan Lu, MS³, Hsiao Tien, PhD³, Melanie Thompson, MD⁴, Mark Thrun, MD⁵, Tracey Wilson, PhD⁶, April Timmons, BS⁶, Andrew Yale⁵, Jacquel Clemons, MPH⁴, Evelyn Byrd Quinlivan, MD¹, and Julie Wright, Pharm D⁷. (1) School of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27599, 919.843.1832, shilpa_patel@med.unc.edu, (2) Cecil G. Sheps Center for Health Services and Research, 725 Airport Road CB7590, Chapel Hill, NC 27599, (3) Biostatistics, University of North Carolina, Chapel Hill, McGavran-Greenberg Hall CB# 7420, Chapel Hill, NC 27599, (4) AIDS Research Consortium of Atlanta, 131 Ponce de Leon Avenue, Suite 130, Atlanta, GA 30308, (5) Denver Health and Hospital Authority, 605 Bannock Street, MC2600; Rm 274, Denver, CO 80204, (6) Preventive Medicine and Community Health, SUNY Downstate Medical Center, Box 1240, 450 Clarkson Avenue, Brooklyn, NY, NY 11203, (7) Truman Medical Center, University of Missouri at Kansas City, 2411 Holmes Street, Kansas City, MO 64108

Background: National guidelines recommend that all HIV medical care providers routinely offer risk reduction counseling in clinical settings.

Methods: We developed, implemented, and evaluated a medical provider-delivered counseling program in 7 US HIV clinics. We surveyed patients before and 6 months after program implementation to assess changes in: 1) how frequently medical providers discussed safer sex practices; 2) whether clinic staff or patients initiated these discussions more; and 3) patients' satisfaction with aspects of their care. We stratified each of the above analyses by sexual partner type (MSM, MSW), age group, ethnicity, and gender.

Results: Of the 1050 HIV positive patients surveyed, mean age was 41 years, 61% were African- American, 31% women, and 67% men (45% MSM, 22% MSW). Among the full sample, patients reported significant increases in percent change in scores for the following items: 1) frequency of providers' discussing safer sex (28%; p<.0001) and IDU practices (49%, p<.0001); 2) providers' initiating a conversation about safer sex (9%; p=.0002); 3) satisfaction regarding health care (14%; p=.008) and relationship with provider (9%; p=.003). Increases were noted regarding providers'discussing safer sex with patients when stratified by MSM (33%; p < .0001) the oldest age group (50-65yrs) (45%; p < .0001).

Conclusions: These patients reported significant increases in provider-delivered safer sex counseling after 6 months. They were also more satisfied with their care. Although we cannot stratify yet by dose of provider intervention received, 12 month follow-up and dose collection are underway and may strengthen our conclusions.

Learning Objectives:

• Describe results from a large prevention with positives initiative in the United States.
• Recognize the trends in provider-delivered counseling and care satisfaction among subpopulations.
• Understand the successes and limitations of a prevention with positives initiative in medical settings.

Presenting author's disclosure statement:

Any relevant financial relationships? No