Provider Fatalism Reduces the Likelihood of HIV-Prevention Counseling in Primary Care Settings

Steward, Wayne T.; Koester, Kimberly A.; Myers, Janet J.; Morin, Stephen F.

doi:10.1007/s10461-005-9024-z

Cited by 21 publications

(19 citation statements)

References 37 publications

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“…This finding provides additional evidence of the importance of this belief as an influence on HIV prevention delivery and demonstrates that fatalism makes a difference regardless of visit type. In our prior work (Steward et al 2006), we found that fatalism among a clinic's providers was significantly associated with less PwP counseling. Given the repeated observation of the association between fatalism and prevention, it will be important for future research to explore the relationship in greater detail.…”

Section: Discussionmentioning

confidence: 77%

“…Whether delivered by a primary care provider, a health educator or an HIV-infected peer, the method of addressing HIV prevention in care settings is dependent upon many factors, including providers' attitudes and beliefs (Steward et al 2006;Gerbert et al 1999a). For example, many providers conduct HIV risk assessment and prevention counseling most often during initial patient visits; in some instances, this is the only visit during which HIV prevention issues are addressed .…”

Section: Introductionmentioning

confidence: 99%

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Sex, Risk and Responsibility: Provider Attitudes and Beliefs Predict HIV Transmission Risk Prevention Counseling in Clinical Care Settings

et al. 2007

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We examined factors associated with the frequency of HIV "prevention with positives" (PwP) counseling delivered by providers participating in demonstration projects at 26 clinics. Three hundred and fifteen primary care and support service providers completed a survey assessing the frequency of PwP delivered at initial medical care visits and at regular care visits. Providers reported delivering PwP counseling to more patients at initial visits (67%) than to those returning for regular care (53%; t = 11.8, p < 0.001). During initial and regular care visits, providers reporting a sense of responsibility for conducting PwP and those regularly discussing the risk of reinfection with patients reported significantly more frequent PwP counseling. Providers expressing a belief that no matter how much counseling was delivered, some HIV-infected patients would still infect others (prevention fatalism) reported significantly less frequent counseling at all visits. To improve the quality and quantity of HIV PwP counseling, providers training should address attitudinal barriers and facilitators to counseling and the importance of addressing risk routinely.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Sex, Risk and Responsibility: Provider Attitudes and Beliefs Predict HIV Transmission Risk Prevention Counseling in Clinical Care Settings

et al. 2007

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“…Such provider fatalism has been shown to impede prevention counseling at the clinic level (Steward, Koester, Myers, & Morin, 2006). Providing data to doctors demonstrating the effectiveness of PWP counseling, including ongoing clinic-level feedback, could motivate providers to counsel their patients more (Meyer, 2000;Zebris & Maurer, 2004).…”

Section: Discussionmentioning

confidence: 99%

Translating Concern into Action: HIV Care Providers’ Views on Counseling Patients about HIV Prevention in the Clinical Setting

et al. 2007

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Recent Centers for Disease Control (CDC) guidelines recommend that HIV care practitioners provide HIV prevention counseling to patients at routine medical visits. However, research shows that HIV care practitioners provide such counseling infrequently, presenting a challenge for clinics implementing these guidelines. Our qualitative study of 19 HIV care providers at an infectious diseases clinic in the southeastern US explored providers' beliefs about their patients' HIV transmission behaviors, expected outcomes of conducting HIV prevention counseling, and perceived barriers and facilitators to counseling. Providers' concern about HIV transmission among their patients was high but did not "translate into action" in the form of counseling. They anticipated poor outcomes from counseling, including harm to patient-provider relationships, and failure of patients to change their behavior. They also listed barriers and facilitators to counseling, most importantly time, state reporting policies, and conversational triggers. Implications for implementation of CDC guidelines and clinic-based "Prevention with Positives" programs are discussed.

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“…More recently, a study of physicians found similar results: less than 40% of physicians reported routinely discussing HIV prevention (Gardner, Metsch, Strathdee, del Rio, Mahoney, & Holmber, 2008). Multiple factors appear to influence whether ongoing prevention counseling occurs, including providers' communication style, perceived amount of time required for counseling, whether specific clinic policies were in place, and comfort level discussing sex and drug use with patients (Gerbert, Caspers, Linkins, & Burack, 1999;Morin et al, 2004;Myers et al, 2004;Steward, Koester, Myers, & Morin, 2006).…”

mentioning

confidence: 99%

People Living with HIV are Receptive to HIV Prevention Interventions in Clinical Settings: A Qualitative Evaluation

Koester

Maiorana²,

Morin³

et al. 2012

AIDS Education and Prevention

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Provider Fatalism Reduces the Likelihood of HIV-Prevention Counseling in Primary Care Settings

Cited by 21 publications

References 37 publications

Sex, Risk and Responsibility: Provider Attitudes and Beliefs Predict HIV Transmission Risk Prevention Counseling in Clinical Care Settings

Sex, Risk and Responsibility: Provider Attitudes and Beliefs Predict HIV Transmission Risk Prevention Counseling in Clinical Care Settings

Translating Concern into Action: HIV Care Providers’ Views on Counseling Patients about HIV Prevention in the Clinical Setting

People Living with HIV are Receptive to HIV Prevention Interventions in Clinical Settings: A Qualitative Evaluation

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