Knowledge of HIV Testing Guidelines Among US Internal Medicine Residents: A Decade After the Centers for Disease Control and Prevention's Routine HIV Testing Recommendations

Abstract

Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records. Of the 192 residents surveyed, 130 (68%) completed the survey. Only 58% were aware of universal HIV screening and 49% were aware that Illinois law allows for an opt-out HIV testing strategy. Most of the residents (64%) ordered no more than 10 HIV tests in 6 months. The most frequently reported barriers to HIV testing were deferral because of urgent care issues, lack of time, and the perception that patients were uncomfortable discussing HIV testing. From July 2015 to February 2016, the average HIV testing adherence rate in the 35 health centers was 18.2%. More effort is needed to change HIV testing practices among internal medicine residents so that they will adopt this approach in their future clinical practice. Improving knowledge about HIV testing and addressing other HIV testing barriers are essential for such a successful change.

Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study

“…However, data from the Behavioral Risk Factor Surveillance System (BRFSS) shows that only 36.1% of all adults, and 46% of adults ages 18-64, have reported ever being tested for HIV [4,5]. Despite the USPSTF recommendation, many physicians screen based on risk stratification or by patient request [6-8]. Factors found to increase the likelihood that a person receives an HIV test include: being MSM [9,10], a young adult [11], black [10,12], having recent STD testing or an STD diagnosis [13], and having access to HIV screening [13].…”

Using a report card to increase HIV screening in a large primary care group practice

“…In one study, only half of internal medicine residents were aware of the screening guidelines. 8 In an emergency department setting, many providers were supportive of a testing programme, but fewer were willing to routinely offer HIV screening. 9 Survey data documented barriers including poor overall awareness, time constraints, inadequate linkage-to-care and legal obligations to document consent.…”

Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study (Preprint)

“…However, data from the Behavioral Risk Factor Surveillance System (BRFSS) shows that only 36.1% of all adults, and 46% of adults ages 18-64, have reported ever being tested for HIV [4,5]. Despite the USPSTF recommendation, many physicians screen based on risk stratification or by patient request [6][7][8]. Factors found to increase the likelihood that a person receives an HIV test include: being MSM [9,10], a young adult [11], black [10,12], having recent STD testing or an STD diagnosis [13], and having access to HIV screening [13].…”