New Guidelines Aim to Help Health Care Providers Incorporate HIV Prevention into Ongoing Care of Persons Living with HIV

The Centers for Disease Control and Prevention (CDC) today released new guidelines aimed at helping healthcare professionals communicate with their HIV infected patients about what they can do to prevent transmitting the virus to others. The guidelines, the first of their kind, were published in the July 18, 2003, issue of Morbidity and Mortality Weekly Report.

"It's time we merge prevention services for HIV-infected persons into the mainstream of medical care," said Julie L. Gerberding, MD, MPH, CDC director. "These guidelines provide a much-needed roadmap for medical professionals that allows them to work more closely with their HIV-infected patients to reduce HIV transmission."

The guidelines resulted from a collaboration of three Department of Health and Human Services agencies: CDC, the National Institutes of Health (NIH), and the Health Resources and Services Administration (HRSA), and the HIV Medicine Association of the Infectious Diseases Society of America.

The audience for the new guidelines includes physicians and physician assistants, nurses, social workers and others who work in medical settings and provide care to persons living with HIV. The guidelines call for:

Screening patients for risk of HIV transmission. Recommended screening practices include using questionnaires and interviews to assess risk behaviors as well as testing for sexually transmitted diseases (STDs) when appropriate. The guidelines recommend talking to female patients about the possibility of pregnancy to help prevent mother-to-child HIV transmission.

Delivering prevention interventions. Health care providers can help reduce their patients' risk of transmitting HIV through such strategies as delivering prevention messages, providing condoms and printed information, and, when appropriate, referring patients to outside prevention services.

Partner counseling and referral services. The guidelines encourage health care professionals to determine whether patients have notified partners of their infections and to help patients contact local health departments to arrange for partners who have not already been informed to be notified. The guidelines emphasize the importance of reaching partners with counseling and testing services.

"With an estimated 900,000 people in our country living with HIV, prevention strategies for HIV-infected individuals are essential," said Harold Jaffe, MD, director of CDC's National Center for HIV, STD and TB Prevention. "Health care professionals provide a critical link to HIV prevention information and services. They can help equip HIV-infected individuals with the best tools to protect their health and the health of their partners."

While research has shown that some people who are aware of their HIV infections tend to reduce risky behavior, recent reports suggest that many have difficulty sustaining those behavior changes. At the same time, medical professionals who care for HIV-infected patients have not had clear guidance on how to help patients maintain safe behaviors and protect their partners.

The guidelines further the objectives outlined in the new, national HIV prevention initiative that CDC introduced in April 2003. Information about the challenges and opportunities for expanding HIV prevention in medical settings will be presented at the 2003 National HIV Prevention Conference, to be held July 27 – 30 in Atlanta.

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