Liddicoat Rebecca V, Losina Elena, Kang Minhee, Freedberg Kenneth A, Walensky Rochelle P
Department of Medicine, Greater Los Angeles Veterans Affairs, Los Angeles, California 90073, USA.
AIDS Patient Care STDS. 2006 Feb;20(2):84-92. doi: 10.1089/apc.2006.20.84.
Efforts to increase HIV case identification through routine, voluntary HIV testing are hindered by high refusal rates. Our objective was to identify patients most likely to refuse routine HIV testing. We developed a new HIV testing program at four Massachusetts urgent care centers. Patients were asked if they were interested in routine HIV testing. We performed analyses to assess differences in characteristics between those who refused testing and those who accepted it. Data were available for 9129/10,354 (88%) patients offered routine HIV testing from January to December 2002. Of these 9129 patients, 67% refused testing. In the crude analysis, HIV test refusal was associated with female gender, white race, older age, and higher educational level. In multivariate analysis, non-English-speaking patients who were Hispanic, Haitian, and other race were more likely to refuse testing than their English-speaking counterparts. Among all patients, "not at risk" and "already tested" were the most common reasons for test refusal. Two thirds of patients refused routine HIV testing when it was offered in a statewide urgent care-based program. If routine HIV testing programs are to be successful, strategies must be developed to increase HIV test acceptance among patients most likely to refrain from testing.
通过常规自愿性HIV检测来增加HIV病例识别的努力受到高拒绝率的阻碍。我们的目标是确定最有可能拒绝常规HIV检测的患者。我们在马萨诸塞州的四个紧急护理中心开展了一项新的HIV检测项目。询问患者是否对常规HIV检测感兴趣。我们进行了分析，以评估拒绝检测者和接受检测者在特征上的差异。2002年1月至12月，有9129/10354（88%）名接受常规HIV检测的患者的数据可用。在这9129名患者中，67%拒绝检测。在粗分析中，HIV检测拒绝与女性、白人、年龄较大和教育水平较高有关。在多变量分析中，非英语的西班牙裔、海地人和其他种族患者比说英语的患者更有可能拒绝检测。在所有患者中，“无风险”和“已检测”是检测拒绝的最常见原因。在全州基于紧急护理的项目中提供常规HIV检测时，三分之二的患者拒绝了检测。如果常规HIV检测项目要取得成功，就必须制定策略，以提高最有可能不进行检测的患者对HIV检测的接受度。
