与内科医生使用快速 HIV 检测相关的提供者和实践特征。

Provider and practice characteristics associated with use of rapid HIV Testing by general internists.

机构信息

Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA.

出版信息

J Gen Intern Med. 2011 Nov;26(11):1258-64. doi: 10.1007/s11606-011-1764-z. Epub 2011 Jun 28.

DOI:10.1007/s11606-011-1764-z

PMID:21710314

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3208478/

Abstract

BACKGROUND

Rapid HIV testing could increase routine HIV testing. Most previous studies of rapid testing were conducted in acute care settings, and few described the primary care providers' perspective.

OBJECTIVE

To identify characteristics of general internal medicine physicians with access to rapid HIV testing, and to determine whether such access is associated with differences in HIV-testing practices or perceived HIV-testing barriers.

DESIGN

Web-based cross-sectional survey conducted in 2009.

PARTICIPANTS

A total of 406 physician members of the Society of General Internal Medicine who supervise residents or provide care in outpatient settings.

MAIN MEASURES

Surveys assessed provider and practice characteristics, HIV-testing types, HIV-testing behavior, and potential barriers to HIV testing.

RESULTS

Among respondents, 15% had access to rapid HIV testing. In multivariable analysis, physicians were more likely to report access to rapid testing if they were non-white (OR 0.45, 95% CI 0.22, 0.91), had more years since completing training (OR 1.06, 95% CI 1.02, 1.10), practiced in the northeastern US (OR 2.35; 95% CI 1.28, 4.32), or their practice included a higher percentage of uninsured patients (OR 1.03; 95% CI 1.01, 1.04). Internists with access to rapid testing reported fewer barriers to HIV testing. More respondents with rapid than standard testing reported at least 25% of their patients received HIV testing (51% versus 35%, p = 0.02). However, access to rapid HIV testing was not significantly associated with the estimated proportion of patients receiving HIV testing within the previous 30 days (7.24% vs. 4.58%, p = 0.06).

CONCLUSION

Relatively few internists have access to rapid HIV testing in outpatient settings, with greater availability of rapid testing in community-based clinics and in the northeastern US. Future research may determine whether access to rapid testing in primary care settings will impact routinizing HIV testing.

摘要

背景

快速 HIV 检测可增加常规 HIV 检测。大多数先前的快速检测研究都是在急性护理环境中进行的，很少有研究描述了初级保健提供者的观点。

目的

确定能够获得快速 HIV 检测的普通内科医生的特征，并确定这种机会是否与 HIV 检测实践的差异或感知的 HIV 检测障碍有关。

设计

2009 年进行的基于网络的横断面调查。

参与者

共有 406 名社会普通内科医生的医生成员，他们监督住院医师或在门诊环境中提供护理。

主要措施

调查评估了提供者和实践特征、HIV 检测类型、HIV 检测行为以及 HIV 检测的潜在障碍。

结果

在应答者中，有 15％可以获得快速 HIV 检测。在多变量分析中，如果医生是非裔美国人（OR 0.45，95％CI 0.22，0.91），完成培训后时间更长（OR 1.06，95％CI 1.02，1.10），在美国东北部地区执业（OR 2.35；95％CI 1.28，4.32），或其执业包括更高比例的未投保患者（OR 1.03；95％CI 1.01，1.04），则更有可能报告获得快速检测。可以获得快速检测的内科医生报告 HIV 检测的障碍较少。具有快速检测而不是标准检测的更多应答者报告至少有 25％的患者接受了 HIV 检测（51％比 35％，p = 0.02）。但是，获得快速 HIV 检测与在过去 30 天内接受 HIV 检测的患者比例之间没有显着相关性（分别为 7.24％和 4.58％，p = 0.06）。