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APHA Scientific Session and Event Listing

Abigail D. Zeveloff, MPH¹, Shilpa N. Patel, MPH², Carol E. Golin, MD, MPH³, Evelyn Byrd Quinlivan, MD², and Jo Anne Earp, ScD⁴. (1) Department of Health Behavior Health Education, School of Public Health, University of North Carolina - Chapel Hill, Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, 919-949-0486, zeveloff@email.unc.edu, (2) School of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27599, (3) Cecil G. Sheps Center for Health Services and Research, 725 Airport Road CB7590, Chapel Hill, NC 27599, (4) Health Behavior and Health Education, University of North Carolina at Chapel Hill School of Public Health, Campus Box 7440, Chapel Hill, NC 27599

Issues: National guidelines recommend that HIV medical providers incorporate HIV prevention into routine clinical visits. However, the extent to which providers deliver prevention counseling is unclear. Factors that impede or facilitate counseling are also unknown. To develop and refine effective prevention with positives (PwP) programs in medical settings, we need to understand providers' experiences providing PwP counseling. Description: We implemented and evaluated a provider-delivered counseling program aimed at reducing risk behaviors of HIV+ patients. One year post implementation, we conducted in-depth, semi-structured interviews of 10 medical providers regarding their counseling practices and experiences with the PwP program. Using grounded theory, we coded the interviews for emergent, salient themes. Lessons Learned: Providers described barriers and facilitators to providing counseling. Barriers included: 1) high provider caseload; 2) limited time per visit; 3) patients' competing health priorities. Facilitators included: 1) providers' increased experience and comfort in discussing sexual behaviors; 2) providers' ability to frame counseling as part of a clinic-wide program; 3) having access to an on-site prevention counselor. Sharing evaluation data and modifying the risk screening form were raised as factors that could help sustain provider delivery of prevention counseling in the future. Recommendations: Overall, providers thought that counseling their patients about HIV prevention was part of their responsibility to help curb the HIV epidemic. Our evaluation suggests that PwP initiatives can be successful at increasing patient-provider communication about transmission behaviors. Implementation of a PwP program is most effective when accompanied by such resources as risk assessment forms and specialized prevention counselors.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify barriers and facilitators to medical practitioners providing prevention counseling to their HIV positive patients,
• Apply the lessons learned from the Prevention for Positives intervention presented to programming in other clinical settings,
• Develop a plan for organizational modifications in the clinical setting to promote provider behavior change for increased counseling activity.

Keywords: Providers, HIV Interventions

Presenting author's disclosure statement:

Not Answered