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MDs Need to Counsel HIV Patients Better

Updated:
ATLANTA (AP) _ Doctors in major U.S. cities aren't doing enough counseling of HIV patients to prevent the spread of the virus, researchers reported Tuesday in a government-funded study.

Doctors in Atlanta, Baltimore, Los Angeles and Miami were more likely to provide HIV risk-reduction counseling to those newly diagnosed with the virus that causes AIDS than to existing HIV patients, according to the study, funded by the Centers for Disease Control and Prevention.

About 60 percent of the 317 doctors surveyed said they regularly provided counseling _ which health officials believe is critical to curbing the spread of the infectious disease _ to their new HIV patients. However, only 14 percent of the doctors said they routinely counseled those patients who have had the virus.

Not counseling HIV patients is ``a missed opportunity for delivery of prevention messages,'' study authors said in this month's issue of the American Journal of Public Health.

Recent outbreaks of sexually transmitted diseases, particularly syphilis, among gay and bisexual men in major U.S. cities _ including Atlanta _ have caused health officials to be concerned that the groups are abandoning safe sex practices and HIV rates could rise.

``We're not used to counseling patients with HIV,'' said Dr. Carlos del Rio, an Emory University professor of medicine who was one of the study authors.

The problem was that in the past, HIV counseling focused on having sick patients learn how to prepare wills and for the end of their lives. But thanks to modern drug treatments, HIV is no longer a death sentence.

``Now patients are having normal lives _ and having sex is a part of having a normal life,'' del Rio said. ``The counseling we have to do is how to live healthy with HIV to prevent others from getting HIV and how to prevent yourself from getting another STD.''

The study notes that doctors who specialize in treating HIV patients are likely an underused resource in health officials' strategy of curbing HIV and AIDS cases.

Medical evidence shows having doctors talk to HIV patients about the disease can be effective in preventing the spread of it, del Rio said.

The study ``suggests that more education is needed to incorporate HIV prevention to medical care settings,'' del Rio said.

Having enough time to talk to patients was a factor in the study. Those who had a small patient load (1 to 18 patients a month) were nearly three times more likely as doctors with high patient loads (more than 100 patients a month) to counsel new HIV patients.

Even doctors with medium patient loads (19 to 100 patients a month) were nearly twice as likely to talk to HIV patients than doctors with more patients.

Another problem, according to the study, may be that doctors spend too much time emphasizing the need to adhere to HIV-fighting drugs, leaving little other time to discuss how to prevent infecting others.

Federal agencies need to reimburse doctors for counseling, which will happen more frequently when doctors ``get time to do it,'' del Rio said.
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