Risk Analysis: HIV
interpreting these data, and counseling strategies that can be used in the primary care setting.1 The evidence and its interpretation are described thoroughly, as are counseling strategies for changing behavior. We believe that further discussion of counseling strategies, however, is prudent. In particular, we focus on two areas: the discomfort providers and patients experience when discussing sexual matters; and the complex process of changing behavior that starts with the provider's risk assessment, continues with a discussion about the patient's apparent risk and ends with the patient's decision to change or not change behavior.
The first area that deserves more comment is discomfort. Not all
health care providers feel comfortable speaking to patients about a subject as private as oral sex. Patients are usually uncomfortable as well, if not more so, and therefore, they are likely to sense the provider's discomfort. Practical methods for alleviating the discomfort are available.
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