Question | Discussion | References | CME Credit

Updated August 29, 2006

Case 2: Screening for High-risk Behavior

Authors: Emily Darby, MD David H. Spach, MD

A 47-year-old man with an 8-year history of HIV infection presents to your clinic to establish care. He was started on antiretroviral medication 3 months ago by his previous healthcare provider; he has been tolerating the medications well, but is unaware of his current viral load or CD4 count. You note on the intake form that he has poorly controlled type 2 diabetes mellitus and mild hypertension.

Which of the following statements is TRUE regarding screening for high-risk sexual or drug behavior in this patient?

A If he told you he had a steady partner for the past 5 years, it would not be necessary to obtain additional information regarding sexual history.
B Although his diabetes control and response to antiviral medications should be addressed during this visit, screening for high-risk behavior related to HIV transmission should also ideally be performed during the initial clinic visit.
C Patient-administered questionnaires and computer-assisted screening for sexual risk behavior have minimal value since they typically yield reports of fewer sexual high-risk behaviors than those obtained through a face-to-face interview with a clinician.
D Open-ended questions that broach topics such as condom use are ineffective in obtaining useful information regarding sexual history.