2008 HIV Study Results

Identifying Barriers and Facilitators to Routine Human Immunodeficiency Virus Testing

Jennifer Ali BSN and Genese Marshall BSN

Background: In 2006, the Centers for Disease Control and Prevention (CDC) released new and revised recommendations for routine Human Immunodefienciency Virus (HIV) testing that suggest healthcare providers perform routine HIV testing on all patients ages 13-64. Despite these recommendations, primary care providers have failed to expand testing practices. The purpose of this study was to (a) examine HIV testing practices of advanced practice nurses, (b) identify factors that may prevent or facilitate routine HIV testing, and (c) identify associations between those factors and sociodemographic variables.

Methods: Certified nurse practitioners who are members of the Illinois Society of Advanced Practice Nursing were sent electronic mail, requesting participation in a cross-sectional descriptive survey. The survey was posted online for 4 weeks, and the study yielded a 15.2% response rate.

Results: Of participants, 50% were not familiar with the CDC’s new recommendations. The majority (55.8%) of the respondents offer testing routinely to some of their patients, and most (67.9%) use the opt-in approach. Low risk patient status (68.7%) was the most common factor that hinders routine HIV testing. Lack of hospital/clinic standard of care policies (31.3%), lack of patient acceptance (27.6%), and inadequate reimbursement (13.2%) were the most common factors that hinder routine HIV testing. On the other hand, having easy access to a resource list of HIV specialist and hotlines (95.2%) was identified as the most useful facilitator to HIV testing. Continuing HIV education (84.1%), HIV counseling training (86.5%), reducing time needed for pretest counseling (86.8%), reducing time involved in obtaining consent (79.0%), having a staff member conduct HIV counseling and obtain consent (87.6%), and making HIV testing the standard of care for hospitals/clinics (85.0%) were facilitators also identified as potentially helpful.

Conclusion: Understanding the factors that prevent or facilitate routine HIV testing will aid in the development of future interventional strategies to expand testing practices per the CDC recommendations.