Patient Perceptions of Obstetrician-gynecologists’ Practices Related to HIV Testing

Coleman, Victoria H.; Morgan, Maria A.; Carlson, Rebecca; Hawks, Debra; Schulkin, Jay

doi:10.1007/s10995-008-0374-9

Cited by 8 publications

(10 citation statements)

References 5 publications

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“…12 In a survey of patients identified by the Collaborative Ambulatory Research Network, 48% of patients reported being tested based on their obstetrician or gynecologist recommendation. 13 In a New York city community health survey, patients were more likely to have been recently tested if a doctor recommended an HIV test in the past year. 14 In a survey of adults at 9 internal medicine clinics, 92.4% of those who reported getting tested for HIV also reported that their physician had recommended HIV testing.…”

Section: Methodsmentioning

confidence: 99%

Physician Barriers to Successful Implementation of US Preventive Services Task Force Routine HIV Testing Recommendations

Zheng

Suneja

Chou

et al. 2014

J Int Assoc Provid AIDS Care

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In 2006, the US Centers for Disease Control and Prevention issued recommendations supporting routine HIV testing in health care settings for all persons aged 13 to 64 years. Despite these recommendations, physicians are not offering HIV testing routinely. We apply a model that has previously identified 3 central, inter-related factors (knowledge-, attitude-, and behavior-related barriers) for why physicians do not follow practice guidelines in order to better understand why physicians are not offering HIV testing routinely. This model frames our review of the existing literature on physician barriers to routine HIV testing. Within the model, knowledge barriers include lack of familiarity or awareness of clinical recommendations, attitude barriers include lack of agreement with guidelines, while behavioral barriers include external barriers related to the guidelines themselves, to patients, or to environmental factors. Our review reveals that many physicians face these barriers with regards to implementing routine HIV testing. Several factors underscore the importance of determining how to best address physician barriers to HIV testing, including: provisions of the Affordable Care Act that are likely to require or incentivize major payers to cover HIV testing, evidence which suggests that a physician’s recommendation to test for HIV is a strong predictor of patient testing behavior, and data which reveals that nearly 20% of HIV-positive individuals may be unaware of their status. In April 2013, the US Preventive Services Task Force released a recommendation supporting routine HIV testing; strategies are needed to help address ongoing physician barriers to testing.

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Section: Methodsmentioning

confidence: 99%

Physician Barriers to Successful Implementation of US Preventive Services Task Force Routine HIV Testing Recommendations

Zheng

Suneja

Chou

et al. 2014

J Int Assoc Provid AIDS Care

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show abstract

“…A more recent study [23] investigated patient perceptions of HIV testing. Two-thirds (65%) of patients reported having been tested for HIV at some point in the past, though 72% did not recall if their current ob-gyn recommended testing [23].…”

Section: Resultsmentioning

confidence: 99%

“…Two-thirds (65%) of patients reported having been tested for HIV at some point in the past, though 72% did not recall if their current ob-gyn recommended testing [23]. Among pregnant patients, 61% did not recall their current provider having recommended testing, though 82% had been tested at some point, with 71% receiving their test results during the current pregnancy [23]. Young, pregnant, Hispanic and African-American patients were most likely to report that HIV testing had been recommended by their obstetrician-gynecologist.…”

Section: Resultsmentioning

confidence: 99%

Obstetrician-Gynecologists and Perinatal Infections: A Review of Studies of the Collaborative Ambulatory Research Network (2005–2009)

Leddy

Gonik

Schulkin

2010

Infectious Diseases in Obstetrics and Gynecology

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Background. Maternal infection is associated with adverse pregnancy outcomes, and ob-gyns are in a unique position to help prevent and treat infections. Methods. This paper summarizes studies completed by the Research Department of the American College of Obstetricians and Gynecologists regarding perinatal infections that were published between 2005 and 2009. Results. Obstetrician-gynecologists are routinely screening for hepatitis B and HIV, and many counsel prenatal patients regarding hepatitis B and toxoplasmosis. However, other infections are not regularly discussed, and many cited time constraints as a barrier to counseling. A majority discusses the transmission of giardiasis and toxoplasmosis, but few knew the source of cryptosporidiosis or cyclosporiasis. Conclusions. Many of the responding ob-gyns were unaware of or not adhering to infection management guidelines. Obstetrician-gynecologists are knowledgeable regarding perinatal infections; however, guidelines must be better disseminated perhaps via a single infection management summary. This paper identified knowledge gaps and areas in which practice can be improved and importantly highlights the need for a comprehensive set of management guidelines for a host of infections, so that physicians can have an easy resource when encountering perinatal infections.

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“…The provision of information about HIV arose as a way to increase awareness, reduce fear and stigma, and to increase HIV testing acceptance. Studies suggest that prenatal testing rates are lower when women are perceived as low risk by themselves or their providers [2, 14, 15]. …”

Section: Discussionmentioning

confidence: 99%

Routine Prenatal HIV Testing: Women’s Concerns and Their Strategies for Addressing Concerns

Rothpletz‐Puglia¹,

Storm²,

Burr³

et al. 2011

Matern Child Health J

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The purpose of this exploratory study was to solicit women’s opinions about the process of routine prenatal HIV testing to identify strategies for routine testing that will address women’s concerns, increase their level of comfort with testing, and support universal prenatal HIV testing. A convenience sample of English-speaking women between 18 and 45 years of age who were HIV-negative or of unknown HIV status were recruited for focus groups at four diverse community sites in four states. Focus group discussion questions addressed health care provider approaches and actions that would make a woman feel more comfortable with the process of routine prenatal HIV testing. Twenty-five women agreed to participate; most women (64%) were of Black, non-Hispanic race/ethnicity; 44% were 25–34 years of age. Thematic analysis of women’s concerns about routine prenatal HIV testing fell into the following categories: fear, protecting the baby, protecting the woman, confidentiality, and stigma. Women’s strategies for addressing these concerns were related to themes of education and information, normalizing HIV testing, patient–provider relationships, systems, and private communication. Participants offered numerous insightful and practical suggestions for addressing their concerns thereby supporting universal routine prenatal HIV testing. The themes that arose in this study support the conclusion that women will be more comfortable with routine prenatal HIV testing if they are fully informed and knowledgeable about the rationale for HIV testing during pregnancy and their right to decline, and if testing is carried out in a confidential and supportive health care environment.

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Patient Perceptions of Obstetrician-gynecologists’ Practices Related to HIV Testing

Abstract: Many patients did not recall that their obstetrician-gynecologist had ever recommended HIV testing, although the majority had been tested. Efforts should be made to increase communication between obstetrician-gynecologists and their patients related to HIV risk status and HIV testing.

Cited by 8 publications

References 5 publications

Physician Barriers to Successful Implementation of US Preventive Services Task Force Routine HIV Testing Recommendations

Physician Barriers to Successful Implementation of US Preventive Services Task Force Routine HIV Testing Recommendations

Obstetrician-Gynecologists and Perinatal Infections: A Review of Studies of the Collaborative Ambulatory Research Network (2005–2009)

Routine Prenatal HIV Testing: Women’s Concerns and Their Strategies for Addressing Concerns

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