Delivery of an HIV Prevention Counseling Program in an Infectious Diseases Clinic: Implementation Process and Lessons Learned
| Autor: | Lytt I. Gardner, Jo Anne Earp, Catherine A. Grodensky, Abby Zeveloff, Carol E. Golin, E. Byrd Quinlivan, Shilpa N. Patel, Maureen S. Boland, Rebecca Davis, Gary Marks, Christine O'Daniels |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Counseling Male Program evaluation Health Knowledge Attitudes Practice medicine.medical_specialty Attitude of Health Personnel Sexual Behavior Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Article Interviews as Topic Formative assessment Patient Education as Topic Nursing Surveys and Questionnaires Intervention (counseling) Health care North Carolina medicine Humans African american Unsafe Sex business.industry Public health Public Health Environmental and Occupational Health Disease control Infectious Diseases Family medicine Female business Delivery of Health Care Risk Reduction Behavior Program Evaluation |
| Zdroj: | AIDS Patient Care and STDs. 23:433-441 |
| ISSN: | 1557-7449 1087-2914 |
| Popis: | Current national guidelines recommend that all HIV care providers routinely counsel their HIV-infected patients about reducing HIV transmission behaviors. In this article we identify the challenges and lessons learned from implementing a provider-delivered HIV transmission risk-reduction intervention for HIV-infected patients (Positive Steps). Based on a multi-site Centers for Disease Control and Prevention (CDC) initiative, we integrated the Positive Steps program into an infectious diseases clinic in North Carolina. Of the nearly 1200 HIV-infected patients, 59% were African American, 44% were white, 33% were women, and over 50% were between 25 and 44 years of age. We obtained feedback from a community advisory board, input from clinic staff, and conducted formative interviews with clinic patients and providers to achieve overall acceptance of the program within the clinic. Clinic providers underwent training to deliver standardized prevention counseling. During program implementation we conducted a quality assessment of program components, including reviewing whether patients were screened for HIV transmission risk behaviors and whether providers counseled their patients. Once Positive Steps was implemented, on average, 69% of patients were screened and 77% of screened patients were counseled during the first 12 months. In analyses of quarterly exit surveys of patients after their medical exams, on average, 73% of respondents reported being asked about safer sex and 51% reported having safer-sex discussions with their providers across six quarterly periods. Of those who had discussions, 91% reported that those discussions were “very” or “moderately helpful.” Providers reported time and competing medical priorities as barriers for discussing prevention with patients, however, provider-delivered counseling was routinely performed for 12 months. Overall, the findings indicate that the Positive Steps program was successfully integrated in an infectious diseases clinic and received well by patients. |
| Databáze: | OpenAIRE |
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