Training Needs for HIV Risk Assessment with Older Adults: Results from a Family Medicine Resident Survey

Introduction: Older Americans are more likely than young Americans to be diagnosed with HIV infection late in the course of their disease, which can lead to poorer prognoses. Objective: This survey of Family Medicine and transitional year residents at an urban university-affiliated hospital sought to determine the knowledge and practices of the residents in assessing HIV risk with their older patients. Methods: A convenience sample of thirty-two residents participated in a needs assessment survey. Residents were asked about their experience with HIV risk assessment, diagnosis and treatment of HIV infection as well as training needs from their own experience and what they thought would be helpful for practicing primary care physicians. Results: Although older patients may have many of the same sexual and drug use risk factors as younger patients, residents were less likely to ask their older patients, particularly older female patients, about sexual orientation, number of sexual partners and safer sex practices than their younger patients. Similarly, but to a much lesser extent, they were less likely to ask older patients than younger patients about intravenous drug use. Discussion: Our results suggest HIV risk assessment is often overlooked in older adults by resident physicians. There is a critical need to raise the awareness of this bias, and to educate primary care physicians to assess, screen and test their older patients of HIV infection as they would for younger patients to prevent the disease and/or diagnose and treat the disease early to improve their prognosis.