Normalizing HIV Testing in a Busy Urban Sexually Transmitted Infections Clinic

Brooks, Lesley C.; Rietmeijer, Cornelis A.; McEwen, Dean; Subiadur, Julie; Mettenbrink, Christie

doi:10.1097/olq.0b013e318191701c

Cited by 9 publications

(8 citation statements)

References 2 publications

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“…5,[11][12][13][14] Physician barriers to HIV testing include insufficient time, burdensome consent process, lack of knowledge/training about HIV testing and the CDC revised recommendations, difficulty locating HIV testing consent forms, lack of patient acceptance, competing priorities, and inadequate reimbursement. 15,16 A growing body of research has examined efforts to improve HIV testing rates in a variety of health-care settings, including a public, urban medical care system, 17 U.S. Department of Veterans Affairs health-care facilities, 18,19 hospital emergency departments, 20 a sexually transmitted disease (STD) clinic, 21 and community health centers (CHCs). [22][23][24] However, while studies of CHCs have described programs to implement routine testing and largely reported patient-level data, little research to date has examined barriers to implementation among CHC personnel.…”

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confidence: 99%

Barriers to Routine HIV Testing among Massachusetts Community Health Center Personnel

et al. 2011

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confidence: 99%

Barriers to Routine HIV Testing among Massachusetts Community Health Center Personnel

et al. 2011

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“…In a Denver STD clinic, HIV testing increased 1.2% because 79% of patients tested for syphilis were already being tested for HIV before the intervention. 10 Expectations of an HIV testing intervention’s magnitude should be tempered by the limits of the setting, which can be dictated by pre-existing HIV testing and case detection levels. In contrast to the STD clinic setting, an opt-out HIV testing program in a North Carolina emergency department with low pre-intervention levels of HIV testing during this same time period resulted in a 173% increase in HIV testing.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Routine, Opt-Out HIV Testing Program on HIV Testing and Case Detection in North Carolina Sexually Transmitted Disease Clinics

Klein

Messer

Myers

et al. 2014

Sexually Transmitted Diseases

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The impact of routine, opt-out HIV testing programs in clinical settings is inconclusive. The objective of this study was to estimate the impact of an expanded, routine HIV testing program in North Carolina sexually transmitted disease (STD) clinics on HIV testing and case detection. Adults aged 18–64 who received an HIV test in a North Carolina STD clinic July 1, 2005 through June 30, 2011 were included in this analysis, dichotomized at the date of implementation on November 1, 2007. HIV testing and case detection counts and rates were analyzed using interrupted time series analysis, and Poisson and multilevel logistic regression. Pre-intervention, 426 new HIV-infected cases were identified from 128,029 tests (0.33%), whereas 816 new HIV-infected cases were found from 274,745 tests post-intervention (0.30%). Pre-intervention, HIV testing increased by 55 tests per month (95% confidence interval [CI]: 41, 72), but only 34 tests per month (95% CI: 26, 42) post-intervention. Increases in HIV testing rates were most pronounced in females and non-Hispanic whites. A slight pre-intervention decline in case detection was mitigated by the intervention (mean difference [MD]=0.01; 95% CI: −0.02, 0.05). Increases in case detection rates were observed among females and non-Hispanic blacks. The impact of a routine HIV screening in North Carolina STD clinics was marginal, with the greatest benefit among persons not traditionally targeted for HIV testing. The use of a pre-intervention comparison period identified important temporal trends that otherwise would have been ignored.

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“…Comprehensive HIV treatment and care programs organized by the Chinese government demonstrate high-level commitment to HIV control. Promising pilot programs integrating HIV testing at STD clinics have been implemented in the US 32 and Europe. 33 As China’s HIV epidemic increasingly involves sexual transmission, HIV testing at STD clinics and other locations where high-risk individuals seek sexual health services is important.…”

Section: Discussionmentioning

confidence: 99%

Prior HIV Testing Among STD Patients in Guangdong Province, China

Tucker

Yang

et al. 2012

Sexually Transmitted Diseases

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Background Expanding HIV testing is important among individuals at increased risk for sexual HIV transmission in China, but little is known about prior HIV testing experiences among sexually transmitted disease (STD) patients. Methods This cross-sectional study of 1792 outpatients from six public sexually transmitted disease (STD) clinics in Guangdong Province recorded detailed information about ever having been tested for HIV infection in addition to socio-demographic variables, health seeking, clinical STD history, and HIV stigma using a validated survey instrument. Results 456 (25.4%) of the STD patients in this sample had ever been tested for HIV infection. STD patients who were male, had higher income, more education, were at City A and City C, received STD services at public facilities, had used intravenous drugs, and had a history of an STD were more likely to ever receive an HIV test in multivariate analysis. Low perceived HIV risk was the most common reason for not receiving an HIV test. Only 7.7% of the sample reported fear of discrimination or loss of face as influencing their lack of HIV testing. Conclusion Incomplete prior HIV screening among STD patients in China suggests the need for broadening HIV testing opportunities at STD clinics and similar clinical settings attended by those with increased sexual risk.

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Normalizing HIV Testing in a Busy Urban Sexually Transmitted Infections Clinic

Abstract: After the introduction of several changes in clinic procedures, we experienced an increase HIV testing uptake relative to routine syphilis testing. In STI clinics, HIV testing can be made as normal as other routine STI testing.

Cited by 9 publications

References 2 publications

Barriers to Routine HIV Testing among Massachusetts Community Health Center Personnel

Barriers to Routine HIV Testing among Massachusetts Community Health Center Personnel

Impact of a Routine, Opt-Out HIV Testing Program on HIV Testing and Case Detection in North Carolina Sexually Transmitted Disease Clinics

Prior HIV Testing Among STD Patients in Guangdong Province, China

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