Why don't physicians test for HIV? A review of the US literature.
AIDS
; 21(12): 1617-24, 2007 Jul 31.
Article
em En
| MEDLINE
| ID: mdl-17630557
ABSTRACT
OBJECTIVE:
In its 2006 HIV testing guidelines, the Centers for Disease Control and Prevention (CDC) recommended routine testing in all US medical settings. Given that many physicians do not routinely test for HIV, the objective of this study was to summarize our current understanding of why US physicians do not offer HIV testing.DESIGN:
A comprehensive review of the published and unpublished literature on HIV testing barriers was conducted.METHODS:
A literature search was conducted in Pubmed using defined search terms. Other sources included Google, recent conference abstracts, and experts in the field. Studies were divided into three categories prenatal; emergency department; and other medical settings. These categories were chosen because of differences in physician training, practice environment, and patient populations. Barriers identified in these sources were summarized separately for the three practice settings and compared.RESULTS:
Forty-one barriers were identified from 17 reports. Twenty-four barriers were named in the prenatal setting, 20 in the emergency department setting, and 23 in other medical settings. Eight barriers were identified in all three categories insufficient time; burdensome consent process; lack of knowledge/training; lack of patient acceptance; pretest counselling requirements; competing priorities; and inadequate reimbursement.CONCLUSION:
US physicians experience many policy-based, logistical, and educational barriers to HIV testing. Although some barriers are exclusive to the practice setting studied, substantial overlap was found across practice settings. Some or all of these barriers must be addressed before the CDC recommendation for routine HIV testing can be realized in all US medical settings.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Padrões de Prática Médica
/
Sorodiagnóstico da AIDS
/
Infecções por HIV
/
Testes Diagnósticos de Rotina
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos