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The British Columbia Centre for Disease Control (BCCDC) and the Public Health Agency of Canada collaborated in 2002-2003 on a study to evaluate BC primary care physicians' use of STD and HIV counselling guidelines. The authors sought to assess barriers to integrated HIV and STD testing and counselling, with the objectives of understanding barriers to optimal screening and care, and refining practice guidelines to meet the needs of primary care physicians in diverse settings.
The BC College of Physicians and Surgeons membership of general practice/ family medicine practitioners was stratified by practitioner location; 1200 physicians were randomly selected to receive a mailed self-administered questionnaire. 407 completed questionnaires were returned.
Female physicians reported better adherence to practice guidelines on many items compared to their male counterparts, but most physicians did not routinely integrate HIV and STD testing and counselling. Physicians in non-urban areas were more likely to report that they lacked sufficient information on HIV and STD risk and prevention. Although male primary care physicians in BC were more likely to provide care for people with HIV infection, female MDs were more likely to undertake ongoing screening for sexual risk behaviour and STIs among their HIV-positive patients.
Clinical practice guidelines are theoretically equally available to all physicians, but they are not universally used. Physicians may not receive adequate training in sexual health during their medical education, and continuing education opportunities may be limited for physicians outside of urban centres. Accessible and relevant continuing medical education in novel formats is needed to address the gap between ideal and actual practice in HIV and STD prevention, treatment and care in Canada.
Hansen L, Barnett J, Wong T, Spencer D, Rekart M. STD and HIV Counseling Practices of British Columbia Primary Care Physicians . AIDS Patient Care and STDs. 2005 Jan;19(1):40-48.
Barnett J, Spencer D, Beer T, Rekart M, Hansen L, Wong T, Mann J. Evaluating primary care physician STI/HIV counseling practices .
BC Medical Journal. 2004 Oct;46(8):402-406.