What Factors Influence Obstetrician-Gynecologists to Follow Recommended HIV Screening and Testing Guidelines?

Abstract

The results of this study suggest that the provider's perception about the patients' risk for being infected as well as practice type and location are important factors influencing an obstetrician-gynecologist's decision to screen a nonpregnant woman for HIV.

Correlates of Routine HIV Testing Practices

“…10 Since 2007, results from representative surveys of health care workers, including obstetricians/gynecologists (OB/GYNs) providing care to women who were not pregnant, osteopaths, internal medical residents in New York City (NYC) and physicians, nurse practitioners, physician assistants, and midwives in general internal medicine, showed that only up to one-quarter offered HIV testing in compliance with CDC guidelines. 7,13,14,15 The practice of routine HIV testing varies by physician characteristics. OB/GYNs are more likely to report the practice of routine HIV testing in the post-2006 period, presumably since screening of pregnant women for HIV has been CDC's standard of care since 2001.…”

“…OB/GYNs are more likely to report the practice of routine HIV testing in the post-2006 period, presumably since screening of pregnant women for HIV has been CDC's standard of care since 2001. 11,13,14 In contrast, pediatricians seem to be the least likely to routinely offer HIV testing to their patients and tend to view testing for HIV as a lower priority than other adolescent issues, such as sexually transmitted infections, violence, or substance abuse. 16,17 Researchers have found that female physicians seem more willing to adopt routine HIV testing practices, 7,8,11,16,17 as are younger practitioners 11,17 and those who completed training within the past 10 years.…”

“…10 Practice setting has been found to be important in predicting the adoption of routine testing, with physicians from community-based settings more likely than solo/group practitioners to practice routine HIV testing. 8,13 Federally funded studies have reported that routine HIV testing does not seem to have been adopted in ED settings on a widespread basis. 5 Other aspects of practice setting associated with the adoption of routine HIV testing include a high proportion of minority 18 and Medicaid-funded patients, 5,8,10,11,19 access to rapid testing, 18,20,21 and location in urban areas.…”

“…5 Other aspects of practice setting associated with the adoption of routine HIV testing include a high proportion of minority 18 and Medicaid-funded patients, 5,8,10,11,19 access to rapid testing, 18,20,21 and location in urban areas. 10,13,16 An accurate understanding of guidelines by medical practitioners seems to be a prerequisite for successful implementation of routine HIV testing. 17,22 However, studies suggest that physicians in NYS have a limited understanding of the NYS HIV Testing Law.…”

“…The most frequently reported barrier is the physician's belief that patients are not at risk for HIV. 4,13,18,22,25 Other barriers include a lack of time, 8,13,14,15,16,[21][22][23][24]26,27 competing priorities, 6,8,11,18,24,26 or anticipation of patient refusal. 8,18 This study investigates correlates (characteristics of physicians and practice settings, familiarity with the law, and physician perceptions) of routine testing behaviors compatible with the amended HIV Testing Law, approximately 15 months after its effective date, in a representative sample of NYS physicians who provide primary care services.…”