PHYSICIANS PREVENTION OF STD/HTLV III INFECTION

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Primary care physicians for adults are the major care providers for the sexually active adult population. They are essential in providing preventive advice and appropriate counsel about STD control, long a problem which has become more urgent with increasing risk of HIV infection. However, these physicians are believed to be more deficient in knowledge of prevention than of cure of sexually-transmitted diseases, including HIV infection. To be effective, primary care physicians likely need new knowledge and skills. It is hypothesized that an education program of written, and audio-visual cassette materials on current HIV data and STD history taking provided physicians in their offices will be more effective in enhancing knowledge and changing behavior than written information only. More effective yet will be educationaly materials and a scheduled office visit from a simulated sexually active patient followed by written feedback. The project will be done with primary care practitioners, internists, and obstetrics an gynecology physicians (N:3300) in the Washington, D.C. metropolitan area, a high AIDS incidence area. An STD/HIV needs assessment will be done before educational materials are developed. Eligible physicians will be randomly allocated into control, low intervention and high intervention groups and will be surveyed by telephone before and after the educational interventions. Outcome will be measured by changes in knowledge and purported behavior as measured by responses to questionnaire items, and changes in laboratory testing for STD of study physicians for the week prior to each interview. Data on reported gonorrhea and syphillis in the Washington metropolitan area and a control area during the time of the two surveys will also be collected from public health agencies. Specific aims of this project are: 1) Documentation of primary care physician experience, knowledge and behavior regarding HIV infections and STD history taking. 2) Development of educational materials for primary care physicians. Assessment of innovative educational programs for improving physicians' educational materials for primary care physicians. Following the study educational materials will be critiqued and revised and produced for wider dissemination.