Evaluating interviewing techniques for the sexual practices history. Use of video trigger tapes to assess patient comfort.

BACKGROUND: Although physicians recognize the importance of assessing a patient's risk for human immunodeficiency virus (HIV) infection, many are reluctant to explore a person's sexual history, a principal determinant of this risk.
OBJECTIVE: To examine the feasibility of a research design that uses responses to viewing a videotaped interview as a proxy for how patients might feel if they were interviewed using a specific approach, and to determine comfort levels with a variety of interview approaches for conducting HIV risk assessment.
METHODS: Individuals responded to a videotape of several interviewing approaches for HIV risk assessment. Responses to the following aspects were collected: introduction of HIV risk assessment, assessment of patient comfort with the topic, techniques for collecting HIV risk and sexual information, and exploration of sensitive issues not previously identified. Participants expressed levels of comfort by means of a Likert scale to rate their comfort with each approach.
RESULTS: Participants expressed higher comfort levels with an introduction that used a ubiquity statement or lifestyle bridge question. Also, they expressed greater comfort when the interviewer addressed how they felt about responding to questions about their HIV risk. Participants reported highest levels of comfort with both patient-centered and closed-ended interviewing techniques. Women were less comfortable with an open-ended interviewing technique.
CONCLUSIONS: Individuals have different comfort levels for approaches used to assess HIV risk. This trigger tape experimental design to assess comfort levels for interview techniques is feasible for exploring other aspects of physician-patient communication; additional validation studies are recommended.