HIV for providers

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HIV can affect anyone; however, there are many factors that increase the possibility of getting HIV, like racism, poverty, HIV stigma, and homophobia. Health care providers play a key role in HIV prevention by screening patients for their risk and educating them about behaviors that affect exposure and how they can protect themselves and others. 

Health care providers also play a key role in HIV treatment by supporting patients to stay engaged in care and have a healthy future. What you say and how you encourage someone to stay engaged in care (based on their HIV status and life circumstances) can make a huge difference in making your patients feel safe with you as their health care provider.

You can help patients understand how their behavior affects their risk of HIV with just a conversation. 

Reduce stigma surrounding HIV by routinely obtaining the sexual histories of all patients and asking open-ended questions.

Ask your patients using the five P's: partners, practices, protection from STIs, past history of STIs, and pregnancy intention. 

  • “Are you currently having sex of any kind?”
  • “What is/are the genders of your partners?”
  • “In the past few months, how many sexual partners have you had?”
  • “Do you or your partner(s) currently have other sex partners?”

“To understand your risks for STIs, I need to understand the kind of sex you have had recently.”
“Have you had vaginal sex, meaning ‘penis in vagina sex’?” If yes, “Do you use condoms: never, sometimes, or always?”
“Have you had anal sex, meaning ‘penis in rectum/anus sex’?” If yes, “Do you use condoms: never, sometimes, or always?”
“Have you had oral sex, meaning ‘mouth on penis/vagina’?”
“Where do you typically meet your partners?”
“Have you or any of your partners used drugs?”
“Have you ever exchanged sex for your needs (money, housing, drugs, etc)?”

“Do you and your partners discuss STI and HIV prevention?”
“Do you and your partners discuss getting tested?”
“What protection methods do you use?”

“Have you ever been tested for STIs and HIV?”
“Have you been diagnosed with an STI in the past?”
“Have you had any symptoms that keep coming back?”
“Have any of your partners had an STI? Were you tested for the same STI(s)?”

“Do you think you would like to have (more) children in the future?”
“How important is it to you to prevent pregnancy (until then)?”
“Are you or your partner using contraception or practicing any form of birth control?”
“Would you like to talk about ways to prevent pregnancy?”

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Inform patients that testing for STIs is a routine part of good health care. Remind them that treatment for HIV has come a long way and that people with HIV can now live long, healthy and fulfilling lives.

Reference: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, A Guide to Taking a Sexual History