Patients’ Attitudes Toward and Factors Predictive of Human Immunodeficiency Virus Testing of Academic Medical Clinics

Stefan, Mihaela; Blackwell, J. M.; Crawford, Kamau M.; Cykert, Samuel; Martinez, Johanna; Sung, Sun Wu; Holliday, Scott; Landry, Michael; LaVine, Nancy; Lerfald, Nathan; Morris, Jason; Greene, Sheila

doi:10.1097/maj.0b013e3181e59c3e

Cited by 25 publications

(13 citation statements)

References 13 publications

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“…18 Other studies also have found that physician recommendation for HIV testing is associated with acceptance of testing. 19–22 These findings, along with our results, suggest a need for additional campaigns targeting physicians about current HIV testing recommendations. A multimodal intervention study that included physician education initiatives and audit feedback did improve HIV testing rates in a VA system 23 ; such initiatives should be considered for additional VA medical centers.…”

Section: Discussionsupporting

confidence: 67%

Are VA Primary Care Providers Aware of HIV Testing Recommendations for Veterans? Findings at an Urban VA Primary Care Clinic

et al. 2013

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Given the prevalence of human immunodeficiency virus (HIV) in veterans and that nearly 90% of veterans have not been HIV tested, the Veterans Affairs (VA) has recommended routine HIV testing of all veterans. The objective of this study carried out at an urban VA primary care clinic was to assess provider knowledge of recent U.S. Centers for Disease Control and Prevention (CDC) and VA HIV testing recommendations and policies. Fifty-six primary care providers completed a survey. Nearly 40% of providers were unaware of the CDC recommendation to test all persons ages 13 to 64 in health care settings or the VA policy to test veterans of all ages. Over 75% of providers were unaware of the latest requirements for pre- and posttest counseling, and many were unaware of the latest consent process requirements. Educating VA providers about recent HIV testing recommendations and policies may improve the low HIV testing prevalence in the VA.

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Section: Discussionsupporting

confidence: 67%

Are VA Primary Care Providers Aware of HIV Testing Recommendations for Veterans? Findings at an Urban VA Primary Care Clinic

et al. 2013

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“…Other studies have found that individuals may be more likely to accept HIV-testing if another blood test was performed at the same time 10 , and this has been suggested for other health screening outcomes. 11,12 Thus, there may be opportunities to facilitate HIV-testing in healthcare settings around screening for other conditions.…”

Section: Discussionmentioning

confidence: 95%

Healthcare-related correlates of recent HIV testing in New York City

Kim

Thorpe

Myers

et al. 2012

Preventive Medicine

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Objective To examine healthcare-related correlates of recent HIV-testing among New York City (NYC) residents, controlling for socio-demographic and HIV-related risk factors. Methods Using the NYC 2007 Community Health Survey (population-based telephone survey, n=8,911), recent HIV-testing was examined for its association with healthcare-related variables, including medical screening for other conditions, controlling for other HIV-testing correlates using multiple logistic regression. Results Factors associated with a recent HIV test included: provider recommend for an HIV test (Adjusted Odds Ratio [AOR]:10.1, 95% confidence interval [CI]:7.6–13.5), Medicaid versus private insurance (AOR:1.6, 95%CI:1.2–2.1), and having a personal doctor (AOR:1.6, 95%CI:1.3–2.1). The proportion of HIV tests attributed to each factor (attributable fraction [AF] was 49% for provider recommendation, 33% for having a personal doctor, and 8.3% for Medicaid insurance. Among those recommended for other medical screening, factors associated with recent HIV-testing included recent receipt of blood lipid testing (AOR:2.2, 95%CI:1.6–3.0; AF:45%), and Pap smear (AOR:2.7, 95%CI:2.1–3.5; AF:52%). Recent receipt of mammography and colonoscopy were not associated with recent HIV-testing. Conclusions A substantial proportion of recent HIV-testing coverage among New Yorkers may be attributable to healthcare-related factors. Joint medical screening may provide opportunities to increase population HIV-testing coverage.

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“…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. 15 In a survey of African American men in Wisconsin, a doctor’s recommendation was the strongest predictor of having been tested: 96.5% of those who had a regular doctor who recommended HIV testing at the time of the study had been tested. 16 This accumulation of evidence highlights the importance of a physician recommendation for promoting 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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Patients’ Attitudes Toward and Factors Predictive of Human Immunodeficiency Virus Testing of Academic Medical Clinics

Cited by 25 publications

References 13 publications

Are VA Primary Care Providers Aware of HIV Testing Recommendations for Veterans? Findings at an Urban VA Primary Care Clinic

Are VA Primary Care Providers Aware of HIV Testing Recommendations for Veterans? Findings at an Urban VA Primary Care Clinic

Healthcare-related correlates of recent HIV testing in New York City

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

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