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pubmed:otherAbstract |
PIP: General practitioners (GPs) are the main source of personal health advice. They are naturally expected to shoulder some of the burden for behavioral change. Thus, GPs must know about HIV infection and the entire spectrum of human sexual practices. They must also know how to communicate this knowledge frankly and effectively with patients to help them reduce their HIV risk. GPs should use precise and clear terms when providing risk reduction behavior advice. For example, they may need to use colloquial terms for coitus. It is not always easy to know when to use colloquialisms, however. It is perhaps best to depend on one's intuition. A nonjudgemental attitude is essential to effectively communicate risks. Safer sex is not limited to just fewer sexual partners and condom use. Safer sex choices include total abstinence (not likely to be widely accepted), penetrative sex with a condom, and alternatives to penetrative sex. Flavored condoms designed for oral intercourse are unlikely to hold up during anal or vaginal intercourse. Condoms sometimes break. GPs need to be ready to discuss how to open a condom package and how to correctly put on a condom. HIV is transmitted through body fluids/products, especially blood, semen, and vaginal secretions. HIV is transmitted through portals of entry (e.g., breaks in the skin). Since the mouth has defenses against HIV, it is not clear whether bleeding gums are a portal of entry. GPs need to explain to patients that HIV-safe sex is not necessarily safe from other sexually transmitted diseases. For example, gonorrhea is easily transmitted via oral sex. GPs should provide complete, nonjudgemental information to patients and allow them to make their own decisions.
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