Patient Visit Opportunities
Patients’ management of their HIV infection can be complicated by factors such as discrimination, substance abuse, and poverty. Patients may not have the tools to protect themselves and their partners from diseases transmission and illness. Whenever a person living with HIV/AIDS visits, clinicians have the opportunity to:
Provide quality medical care. When indicated, initiate antiretroviral therapy. Address resistance to medication. For patients already on ART, stress the importance of adherence to keep viral load low. If you are not experienced in treating patients with HIV, refer to an HIV specialist.
Identify and treat STDs. STDs have a synergistic effect on HIV infectivity and susceptibility, and their presence indicates risky behavior.1 Immunize against key vaccine-preventable illnesses.2
Assess transmission behaviors and Refer. Screen for risky sexual behavior, alcohol use, drug use, and mental health status. If appropriate, refer to specialized social services, i.e. DEBIs/EBIs, mental health services, substance abuse services, etc.
Discuss sexual and drug-use behavior. Patients need accurate information on factors that increase the risk of HIV transmissions.1 Address guilt or anxiety surrounding sexual activity or drug use.
Communicate prevention messages. Patients can benefit from brief prevention messages on the need for safer sexual behaviors to protect themselves and their partners.1 Explain that a person with an undetectable viral load can still trasmit HIV.
Reinforce changes to safer behavior. Brief behavioral interventions can positively reinforce patient actions to reduce transmission risk.1 Counsel on consistent condom use, reducing number of partners, and use of clean needles and works.
Explain the importance of and facilitate partner notification, counseling, and testing. Health care providers can help prevent patients’ sexual or needle-sharing partners from becoming infected with HIV and from infecting others with HIV.1
1. Centers for Disease Control and Prevention. Prevention IS Care. Incorporating HIV Prevention into the Medical Care of Persons Living with HIV. MMWR. 2003;52(RR-12):1-24.
2. City Health Information. HIV Prevention and Care. New York City Department of Health and Mental Hygiene. Vol. 29(1):1-8, January 2010.