In the campaign to prevent HIV and sexually transmitted infections, counselors like Chief Odood are on the frontlines. When a client comes in to Gay City Health Project, Odood spends a good half hour talking about what steps they can take to lower their risk. Information, he says, is their best defense.
Even so, Odood admits that changing behavior can be a challenge. So instead of prescribing a list of do’s and don’ts, Odood says it’s about letting his clients figure out how to protect themselves.
“One of the questions I ask is, how important is it for you to remain HIV, STI negative,” he says, “and before you walk out this door, what’s one of those things you might possibly be able to do to lower that risk.”
Odood’s strategy is in line with the new HIV recommendations by the International Antiviral Society-USA. The guidelines were published this week in the Journal of The American Medical Association.
Behavior counseling is not new, but it’s one of many tools to prevent HIV that’s not being used often enough. Often it’s the drug that gets the attention. But IAS-USA says both behavior counseling and medication are important.
“There is no such thing as a magic pill, there is no such thing as a pure biomedical intervention,” says UW Professor Dr. Jeanne Marrazo. “Everything involves some degree of behavior change.”
Marrazzo specializes in infectious diseases and is part of the panel that came up with the new guidelines. She says clinicians like herself and behavior specialists haven’t always talked to each other. So when they did, they came up with a broad set of practices to prevent infection and to help those living with the disease, stay healthy.
Marrazzo would like to see doctors change their behavior, too. She says many providers feel more comfortable ordering tests or writing prescriptions than asking patients about their sex lives, but those conversations are critical.
“People think patients are going to perceive some of these conversations as sensitive, or unwelcomed, and there has been research to show it’s the opposite, that people actually want to talk about these things,” she says. “I can’t tell you how many patients, when I ask them these questions, especially about sexual behaviors, say you know, I’m really glad you asked that.”
Marrazzo says these conversations can help change patients’ behavior and also gives doctors an indication of who may benefit from new drugs that can lower their risk of infection.
The panel also recommends that all adults be tested for HIV at least once in their lives.
