Video Doctor Helps HIV Patients

I am a self-diagnosed hypochondriac. You name a disease, I am sure I have it. Any new health alerts that pop up on MSNBC are voraciously read to scan for any weird symptoms that might match up to anything I have been feeling. That crick in my neck that I am positive I got from napping with the oversized pillow under my head at my mom’s house justifies an appointment with my physician so I can be sure it isn’t, in fact, meningitis. This is why when I do see my doctor, after twiddling my thumbs in the waiting room for almost an hour, I always feel as if I am rushed through a series of questions and procedures without an adequate amount of time to speak to my doctor about my unwarranted fears and self-diagnoses. If only there was something more beneficial to do during that wait time instead of reading a five year-old issue of People magazine. Fortunately, a new video program called Positive Choice is planning on making use of that frequent down-time in the waiting room to help patients who are suffering from HIV cut back on any risky behavior they may be engaging in.

The great news about this new interactive program is that it has proven to decrease risky drug and sex behaviors in patients diagnosed with HIV. Positive Choice is a computerized interaction that makes use of a doctor (played by an actor) on screen to create a patient-doctor conversation that assesses risks the patient may be engaging in. As the patient answers questions, the program plays video clips of the doctor who provides counseling on those issues addressed in the interaction. This computerized “counseling session” lasts just under half an hour and utilizes the time that a patient would normally be waiting in the waiting room. The video session always ends with a clip of the doctor advising the patient to discuss any risky sexual or drug behaviors they may be engaging in with their physician during their scheduled appointment.

In a study performed at five different San Francisco HIV clinics, the lead author of the program Paul Gilbert states, “Our most striking finding was that many of our intervention arms participants eliminated risky behaviors altogether—38% who reported unprotected sex at baseline reported no vaginal or anal sex without a condom after the intervention. 44% who had been using drugs at the first visit had stopped using all drugs at the conclusion of the study.” Over 900 patients were screened for this program and were split between the control arm and intervention arm. The study shows that even those participants who admitted to continuing with risky sexual or drug behaviors had fewer sexual partners each month and used drugs a fewer number of days per month. The co-author of the study David Bangsberg says “We need better ways to support patients’ healthy decisions. Positive Choice is an efficient, user friendly way to use clinic waiting time to help HIV-positive patients reduce risky behaviors, which not only benefits the wellbeing of the patients but also supports broader public health goals.”  Barbara Gerbert, one of the program’s senior authors, adds that the program “does not replace a patient’s healthcare provider, but facilitates and supports an important dialogue.”