Clinician Utilization of Best Practices for HIV Care and Status Disclosure: A Cross-Sectional Study

Victor N Ede,Robina Josiah Willock,Gregory Strayhorn,Elleen Yancey,Harold Stringer

doi:10.4236/ojpm.2014.48074

Abstract

Determining the baseline utilization of best practices among clinicians, with regard to HIV care and disclosure of status to at-risk partners, is critical to addressing HIV prevention issues and disease transmission. In this study, we examined clinicians' utilization of best practices for HIV/AIDS care and the disclosure of HIV status to sexual and needle-sharing partners (HSSNSP). We conducted a cross-sectional survey of 100 clinicians to assess knowledge, attitude, and behavior towards best practices for HIV care and disclosure of HSSNSP. Multiple logistic regression analysis was used to determine factors associated with the utilization of clinical best practices for HIV care and disclosure of HSSNSP. Forty eight percent of the participants revealed poor behaviors. Fifty six percent showed less positive attitudes towards clinical best practices for HIV care and disclosure of status. Less than half (32%) of the participants had earned at least 1 HIV/AIDS CME credit in the past two years. Our study showed strong associations between the utilization of best practices for HIV care and the disclosure of status, and clinician attitudes and knowledge levels. Further research that aims to improve knowledge and attitudes on clinical best practices for providing HIV/AIDS care and the disclosure of status is needed. This improvement may lead to increase in the utilization of best practices for HIV care and disclosure of status, and contribute to decreases in disease transmission rates.

Highlights

Despite major advances in HIV treatment, the incidence of HIV infections in the United States has remained relatively unchanged since the 1990s with around 49,000 cases per year [1]-[4]
The participants were similar to the distribution of the total population of medical residents and attending physicians in the general medical school, Atlanta Medical Association (AMA), and Georgia State Medical Association (GSMA) populations based on gender, years of training, and specialty
Exploring policies that would increase HIV/AIDS-related Continuing Medical Education (CME) participation rates among physicians, and finding interventions that focus on enhancing positive attitudes toward best practices for HIV/AIDS care and disclosure of HIV status to sexual and needle-sharing partners (HSSNSP) maybe of high yield in improving behavior and reducing HIV incidence

Summary

Introduction

Despite major advances in HIV treatment, the incidence of HIV infections in the United States has remained relatively unchanged since the 1990s with around 49,000 cases per year [1]-[4]. The steady incidence of HIV is due, in part, to the high rates of undiagnosed infections. Clinicians have the potential to significantly influence patients’ risk for transmission of HIV by screening for HIV transmission risk behaviors; communicating prevention messages; discussing sexual and drug use behavior; facilitating disclosure of HIV status to sexual and needle-sharing partners, counseling and testing; and identifying and treating other sexually transmitted diseases [6]. The optimal use of clinical best practices in HIV care and partner notification of HIV status, among clinicians may significantly contribute to the incidence of the disease, and HIV/AIDS health outcomes. According to a study in 2004 [8], about 35% of physicians appear to be relatively non-compliant with general best practice guidelines, resulting in potentially devastating consequences to patients’ health

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Conclusion