J Midwifery Womens Health. 2011 Jul-Aug;56(4):395-399. doi: 10.1111/j.1542-2011.2011.00031.x. Epub 2011 May 31.
Family planning centers can play an important role in HIV screening, education, and risk-reduction counseling for women who are sexually active. This article describes how 1 urban Title X-funded family planning clinic transitioned from using a designated HIV counselor for targeted testing to a model that uses clinic staff to provide integrated, routine, nontargeted, rapid HIV testing as standard of care.
Representative clinic staff members developed an integrated testing model that would work within the existing clinic flow. Education sessions were provided to all staff, signs promoting routine HIV testing were posted, and patient and clinician information materials were developed. A review of HIV testing documentation in medical charts was performed after the new model of routine, nontargeted, rapid HIV testing was integrated, to determine any changes in patient testing rates. A survey was given to all staff members 6 months after the transition to full integration of HIV testing to evaluate the systems change process.
Two years after the transition, the rate of patients with an HIV test in the medical chart within the last 12 months increased 25.5%. The testing acceptance rate increased 17%. Sixteen HIV seropositive individuals were identified and linked into medical care. All surveyed clinic staff agreed that offering routine HIV screening to all patients is very important, and 78% rated the integration efforts as successful.
Integrating routine HIV screening into a family planning clinic can be critical to identifying new HIV infections in women. This initiative demonstrated that routine, nontargeted, rapid HIV screening can be offered successfully as a standard of care in a high-volume, urban, reproductive health care setting. This description and evaluation of the process of changing the model of HIV testing in a clinic setting is useful for clinicians who are interested in expanding routine HIV testing in their clinics.
计划生育中心可以在为有性活跃的女性提供 HIV 筛查、教育和降低风险咨询方面发挥重要作用。本文介绍了 1 家城市计划生育 X 项目资助的计划生育诊所如何从使用指定的 HIV 顾问进行有针对性的测试过渡到使用诊所工作人员提供综合、常规、非针对性、快速 HIV 测试作为标准护理的模式。
有代表性的诊所工作人员制定了一个综合测试模型，该模型将在现有诊所流程内运作。为所有员工提供了教育课程，张贴了促进常规 HIV 测试的标志，并开发了患者和临床医生信息材料。在整合常规、非针对性、快速 HIV 测试的新模式后，对医疗记录中的 HIV 测试文档进行了审查，以确定患者测试率的任何变化。在全面整合 HIV 测试后 6 个月，向所有员工进行了调查，以评估系统变更过程。
在过渡两年后，过去 12 个月内医疗记录中有 HIV 测试的患者比例增加了 25.5%。测试接受率增加了 17%。发现了 16 例 HIV 血清阳性个体，并将其纳入医疗护理。所有接受调查的诊所工作人员都认为向所有患者提供常规 HIV 筛查非常重要，并且 78%的人认为整合工作是成功的。
将常规 HIV 筛查纳入计划生育诊所对于识别女性中的新 HIV 感染至关重要。这项倡议表明，在高容量的城市生殖健康保健环境中，作为标准护理，可以成功提供常规、非针对性、快速 HIV 筛查。对诊所环境中 HIV 测试模型变更过程的描述和评估对有兴趣在其诊所扩大常规 HIV 测试的临床医生很有用。
