The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006
276

Correlates of STI clinic patient comfort discussing HIV/STI prevention with healthcare providers

Jocelyn D. Patterson1, Fan Zhang1, Gregory L. Greenwood2, Jeffrey Klausner3, C. Kevin Malotte4, Lydia O'Donnell5, Carl O'Donnell5, Cornelis Rietmeijer6, Douglas Richardson6, Shelley Vrungos4, and Lee Warner7. (1) NCHSTP/DHAP/PRB, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail stop E-37, Atlanta, GA, USA, (2) UCSF/CAPS, San Francisco, CA, USA, (3) STD Prevention and Control Services, San Francisco Department of Public Health, 1360 Mission St., Suite 401, San Francisco, CA, USA, (4) Community Health and Social Epidemiology Program, California State University, Long Beach, CA, USA, (5) EDC, Newton, MA, USA, (6) Denver Public Health, Denver, CO, USA, (7) NCCDPHP/DRH, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA


Background:
Patients comfort discussing HIV/STI prevention with their healthcare provider may facilitate the initiation of risk reduction strategies. Little is known, however, about patient-provider communication in STI clinic settings.

Objective:
To examine correlates of STI clinic patients comfort discussing HIV/STI prevention with their healthcare provider.

Method:
Data analyzed were from a two-arm multi-site intervention trial designed to evaluate the effectiveness of a brief educational video viewed by patients in STI clinic waiting rooms (video vs. no video). Participants (N=1626) completed an audio computer-assisted self interview following their clinic visit. Multivariate analyses were used to identify demographic and behavioral correlates of patient comfort discussing the following topics with their healthcare providers: (1) issues about sexual risks, (2) motivation and skills to practice safer sex, and (3) HIV/STI testing.

Result:
Intervention condition was not associated with level of patient comfort. Overall, most patients were "quite” or "extremely" comfortable talking with their healthcare provider about sexual risk (67%), practicing safer sex (70%), and HIV/STI testing (68%). Participants with at least a college education were more comfortable discussing their sexual risk (OR=1.48, p<0.001) and HIV/STI tests (OR=1.34, p< 0.05) compared with participants with less education. Regarding discussion of HIV/STI testing, women were more comfortable than men (OR=1.39, p<0.05), and men self-identifying as gay were more comfortable than participants identifying as heterosexual (OR=1.69, p< 0.05) or bisexual (OR=1.61, p<0.05). Having a high-risk partner was not associated with participants' level of comfort discussing HIV/STI prevention strategies.

Conclusion:
Most STI clinic patients were comfortable discussing HIV/STI prevention with their healthcare provider. Patients with lower levels of education, as well as heterosexual and bisexual men, may have greater discomfort in these encounters.

Implications:
New strategies may be needed to engage subgroups of the STI patient population in prevention discussions with clinic providers that are both comfortable and effective.

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