How medical students screen for HIV with standardized patients establishing care.

How Medical Students Screen for HIV with Standardized Patients Establishing Care AUTHORS Christopher J. Brown, B.S., B.A. Candidate; Emily J Noonan, PhD, MA; Laura A. Weingartner, PhD, MS BACKGROUND Approximately 1.1 million people in the U.S. are living with HIV. The US Preventive Services Task Force (USPSTF) recommends HIV testing for everyone 15-65 years old at least once regardless of sexual activity, with more frequent testing for those considered at risk. METHODS Rising third-year medical students were recorded taking health histories from standardized patients. These recordings were coded for HIV screening, including: risk factors such as unprotected sex, intravenous drug usage, multiple partners, patient/partner HIV status; contextualization by student as to how screening questions related to HIV; and discussion tone (accusatory, informative, or non-judgmental). RESULTS Of the 71 sampled encounters, students identified whether the patient knew their STI status without mentioning HIV status, and 10 students explicitly identified whether the patient knew their HIV status. Similarly, 13 students discussed the STI status of the patient’s partner(s) without mentioning HIV, while only 4 students discussed the HIV status of the patient’s partner(s). In total, only 7 out of 71 students recommended HIV testing to their patient. When discussing patient status, most students (34) were non-judgmental, but one used an accusatory tone while eight were informative. DISCUSSION The results show a lack of explicit HIV discussions and testing recommendations to patients despite USPSTF recommendations that all patients be tested. This study highlights that even when STI status is discussed, many students do not specify HIV status, an important distinction when providing preventive care. Future studies should address how perceived patient risk for HIV and patient identity impact HIV testing recommendations