Clinicians should address prevention during routine clinical encounters for all patients, regardless of race, age, gender, sexual orientation, or antiretroviral (ARV) status, in one or more of the following ways:
- Assessing the patient's current level of risk or willingness to address specific sexual or drug-using risk behaviors
- Assessing the patient's readiness to think about prevention
- Discussing specific goal-oriented harm-reduction strategies
Clinicians should frame prevention messages within the context of maintaining the patient's health. Consistent messages should be reinforced by members of the healthcare team.
Clinicians should encourage human immunodeficiency virus (HIV)-infected patients to assume personal responsibility to maintain their health and to prevent HIV transmission to others. Patients should also be encouraged to carry out their responsibility to inform sexual and needle-sharing partners of their HIV infection.
Key Points:
- Prevention messages should be brief and should be tailored specifically to each patient's situation and lifestyle.
- Ensuring that prevention messages are consistently delivered by different members of the healthcare team is a key element of delivering effective prevention counseling.
Models for Prevention Counseling According to the Clinical Environment
In addition to directly discussing prevention issues with patients, clinicians should establish alliances with others who can also deliver these messages as part of the healthcare team.
At institutions where staff members other than the clinician provide the bulk of risk-reduction counseling, regular communication is imperative so that both the clinician and counselor are providing the same message.
Spectrum of Interventions
Clinicians should use a spectrum of prevention interventions in the clinical setting, including education, assessment, counseling, medical screening, and referral to both internal and external resources.
Materials and Tools to Augment Preventive Messages
Prevention messages, including printed materials and posters, should be visible and part of the clinical environment. Condoms should also be readily accessible.
The Role of Referrals
Clinicians should be familiar with community prevention resources, including peer education and support, and should make this information readily available in the clinical setting.
Clinicians should refer substance-using patients to treatment programs or other substance use services that best meet the patient's needs.
Clinician Education
All clinical staff should be educated about HIV prevention and trained to effectively deliver prevention messages to patients.
