Abstract: | SUMMARY With epidemiological trends indicating that Acquired Immune Deficiency Syndrome (AIDS) is the third leading cause of death among women ages 25 to 44 in the United States, it is becoming increasingly important to deal with the issue of Human Immunodeficiency Virus (HIV) prevention for women. Recommendations for primary and secondary prevention strategies tailored to the needs of women have been formulated. Such calls have included the recommendation that prevention efforts be intensified in medical settings regularly frequented by women. One setting identified is that of gynecological and obstetric services where HIV risk assessment, testing, and counseling would be an excellent means of reaching a maximum number of women of child-bearing age. Despite calls by the American College of Obstetricians and Gynecologists for OB/ GYN service providers to engage in HIV prevention, research has shown that physicians remain reluctant to address the issue with patients. This study explored the likelihood of physicians and other health service providers to engage in HIV prevention through risk behavior assessment, HIV testing, and HIV counseling by requesting information from female drug abusers not currently in substance abuse treatment. Sixty percent of the drug abusing women in this study did not receive HIV information from their health care provider, 70% did not receive HIV counseling, 68% were not offered HIV testing, and 66% were not asked to provide a drug history. Of those participants who had not been asked to provide a drug history, almost half indicated that they would have been willing to provide truthful answers had they been asked. These findings indicate that a prime opportunity for HIV prevention is being missed by women's health care providers. Neglecting to ask female patients about their drug use history and to explore their risk for HIV infection can have dire consequences for these women. Early intervention is less likely if the topic is not broached by service providers, increasing the likelihood of infection and the spread of the disease. |