HIV risk assessment

Abstract

In this issue of the Journal, Gerbert and colleagues discuss the evidence for HIV transmission via oral sex, the difficulties in interpreting these data, and counseling strategies that can be used in the primary care setting.1 The evidence and its interpretation are described thoroughly, as are counseling strategies for changing behavior. We believe that further discussion of counseling strategies, however, is prudent. In particular, we focus on two areas: the discomfort providers and patients experience when discussing sexual matters; and the complex process of changing behavior that starts with the provider's risk assessment, continues with a discussion about the patient's apparent risk and ends with the patient's decision to change or not change behavior.