Development and Validation of an HIV Risk Exposure and Indicator Conditions Questionnaire to Support Targeted HIV Screening

Elías, Maria Jesús Pérez; Gómez-Ayerbe, Cristina; Elías, Pilar Pérez; Muriel, Alfonso; Alberto, Santiago Diaz de; Martinez-Colubi, María; Moreno, A. Capote; Santos, Cristina; Polo, Lidia; Barea, Rafa; Robledillo, Gema; Uranga, Almudena; Agustina, Cano Espín; Quereda, Carmen; Dronda, Fernando; Casado, José L.; Moreno, Santiago

doi:10.1097/md.0000000000002612

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…A commercial rapid HIV test (INSTI, BioLytical Laboratories, Richmond, BC, Canada) with high sensitivity and specificity (> 99% for both) was performed for all participants. In addition, all participants were asked to fill out a validated HIV risk of exposure and indicator conditions (RE&IC) questionnaire at the time of inclusion in the study [28]. The questionnaire consists of 6 items that investigate the risk of exposure to HIV (based on identified HIV routes of transmission), with 14 items related to HIV indicator diseases (which are based on a selection of the ‘ HIV Indicator Diseases across Europe Study’ (HIDES) [29,30]).…”

Section: Methodsmentioning

confidence: 99%

“…Posters and brochures were placed in both locations to announce the study. In a confidential setting, after providing informed consent, all participants responded to the RE&IC questionnaire [28] and were tested for HIV with rapid tests. The study activities were carried out by the trained nurse practitioners: nine nurses in the emergency department and two nurses in the primary care center.…”

Section: Methodsmentioning

confidence: 99%

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Impact of a structured HIV testing program in a hospital emergency department and a primary care center

et al. 2019

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Introduction HIV testing guidelines are poorly implemented in most clinical settings. The best screening strategy and healthcare scenario are still unknown. The aim of our study is to evaluate the impact of a structured HIV testing intervention (DRIVE), compared to HIV testing as routinely performed in clinical practice, in two different clinical settings: a primary care center and an emergency department. Methods Prospective evaluation of an HIV testing strategy in two clinical settings from the same healthcare area. The DRIVE program included trained nurse practitioners to perform the screening, a questionnaire to assess the risk of exposure and HIV indicator conditions (RE&IC), and rapid HIV tests. The main variables between the DRIVE program and clinical practice were the absolute number of newly diagnosed HIV infections and testing coverage. Results The DRIVE program included 5,329 participants, of which 51.2% reported at least one positive answer in the questionnaire. The estimated HIV testing coverage was significantly higher in the DRIVE program than in the routine clinical practice (7.17% vs. 0.96%, p < 0.001), and was better in the primary care center than in the emergency department with the two strategies. Twenty-two HIV-positive people were identified, with a rate of 8.6‰ in the emergency department vs. 2.2‰ in the primary care center (p = 0.001). A higher rate of new HIV diagnoses was found in the DRIVE program compared to routine clinical practice (29.6 vs. 3.1 per 100,000 patients attended; p < 0.001). Conclusions An easy-to-implement, structured intervention increased the absolute number of new HIV diagnoses and HIV tests, compared to routine clinical practice.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Impact of a structured HIV testing program in a hospital emergency department and a primary care center

et al. 2019

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“…Different tools are being developed for this purpose, such as the creation of questionnaires to evaluate risk behaviors and HIV-indicator conditions [29–31]; this would facilitate a decision about the test offer. Exhaustive directed screening might achieve similar or better HIV diagnosis rates than non-directed or universal screening; it is more focused, and uses fewer resources than universal screening while maintaining a predictive negative value of 100% [32].…”

Section: Discussionmentioning

confidence: 99%

Outcome of an HIV education program for primary care providers: Screening and late diagnosis rates

et al. 2019

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Background Late HIV diagnosis remains one of the challenges in combating the epidemic. Primary care providers play an important role in screening for HIV infection. Our study aims to evaluate the relationship between knowledge and barriers to HIV testing and screening outcomes. The impact of an education program for primary care providers, towards improving HIV testing and late diagnosis rates, is also assessed. Methods A self-administered questionnaire that was developed within the framework of the European project OptTEST was used to examine HIV knowledge and barriers to HIV testing scores before and after being involved in an HIV education program. A quasi-experimental design with pre- and post-intervention measures was performed to investigate its impact. We performed multivariable logistic regression analysis to assess the relationship between variables for the HIV testing offer. Results A total of 20 primary care centers and 454 primary care staff were included. Baseline OptTEST results showed that more knowledgeable staff offered an HIV test more frequently (OR 1.07; CI 95% 1.01–1.13; p = 0.027) and had lower barrier scores (OR 0.89; CI 95% 0.77–0.95; p = 0.005). Nurses had lower scores in knowledge-related items (OR 0.28; CI 95% 0.17–0.46; p<0.001), but higher scores in barrier-related items than physicians (OR 3.28; CI 95% 2.01–5.46; p<0.001). Specific centers with more knowledgeable staff members had a significant association with a greater level of new HIV diagnosis rates (OR 1.61; CI 95% 1.04–2.49; p = 0.032). After the intervention, we found that 12 out of 14 individual questions showed improved scores. In the 6 months after the training program, we similarly found a higher HIV testing rate (OR 1.19; CI 1.02–1.42; p = 0.036). Conclusions This study highlights the association between knowledge and barriers to HIV testing, including HIV testing rates. It shows that it is possible to modify knowledge and reduce perceived barriers through educational programs, subsequently improving HIV screening outcomes.

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“…Publications on the time it takes patients and survey takers to fill out individual questionnaire items have reported varying times needed from less than 10 seconds to over one minute per item. 16, 17 The forms encountered were quite diverse. Many of the forms did ask some similar questions but there were also many questions that were unique or sought different information about a similar topic.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Disability Insurance Assistance as a Specific Intervention by Physiatrists at a Cancer Center

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Silver

et al. 2017

American Journal of Physical Medicine &Amp; Rehabilitation

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Because of their expertise, physiatrists provide disability insurance assistance for cancer survivors. In this brief report, we perform a descriptive retrospective analysis of all new (354) outpatient physiatry consultations from 1/1/2009 – 12/31/2013 at a National Cancer Institute Comprehensive Cancer Center. Disability and/or work accommodations were brought up at some point with the physiatrist during the duration of their care for 131/354 (37%) patients. More than 90% of the discussions took place during the first visit. Of those patients who had a documented disability/employment discussion, 58/131 (44.3%) patients were originally referred for disability assistance specifically and 58/131 (44.3%) also had disability insurance paperwork completed by the physiatrist. Outcomes of initial physiatry disability insurance assistance were 45/58 (77.6%) approved/renewed, 5/58 (8.6%) denied and 8/58 (13.8%) unknown/died during the disability application process. The median form size was 33 items (standard deviation=25.95). This study is the first of its kind and provides an initial look at work-related discussions and support with disability insurance paperwork as a specific intervention provided by physiatrists at a cancer center. The results are compelling and demonstrate that physiatrists frequently provide these interventions. These interventions take considerable time and effort but are generally successful.

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Development and Validation of an HIV Risk Exposure and Indicator Conditions Questionnaire to Support Targeted HIV Screening

Abstract: Supplemental Digital Content is available in the text

Cited by 14 publications

References 22 publications

Impact of a structured HIV testing program in a hospital emergency department and a primary care center

Impact of a structured HIV testing program in a hospital emergency department and a primary care center

Outcome of an HIV education program for primary care providers: Screening and late diagnosis rates

Evaluating Disability Insurance Assistance as a Specific Intervention by Physiatrists at a Cancer Center

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