An overview of recent evidence on barriers and facilitators to HIV testing.

ABSTRACT

BACKGROUND: To address the issue of undiagnosed HIV infections, the Public Health Agency of Canada released the Human Immunodeficiency Virus-HIV Screening and Testing Guide in 2012, which identified several barriers and facilitators for HIV testing. OBJECTIVE: The objective of this overview is to summarize the most recent evidence regarding barriers and facilitators to HIV testing, to expand upon the research conducted for the HIV Screening and Testing Guide. METHODS: A review of the literature published between 2010 and 2014 was conducted using Scopus, PubMed (MEDLINE), and the Cochrane Library; websites of groups such as the Centers for Disease Control and Prevention, European Centre for Disease Prevention and Control, Australian Department of Health, and New Zealand Ministry of Health were searched for recent reports. Studies were categorized based on the barrier or facilitator identified, and the results were summarized. RESULTS: In addition to the known barriers of lack of perceived risk, lack of comfort or knowledge, provider time constraints, and fear of the diagnosis, stigma and discrimination, new studies have identified additional barriers including fear regarding disclosure or lack of confidentiality, lack of access, lack of compensation of providers, and lack of human resources to carry out testing. In addition to the known facilitators of increased awareness and normalization of HIV screening and testing, opt-out testing was identified as a facilitator in recent studies. CONCLUSION: Since 2010, research has advanced our knowledge of barriers and facilitators and can be applied to help decrease the number of undiagnosed HIV infections.