1HIV STI Department, Health Protection Agency, London, UK.
Sex Transm Infect. 2012 Dec;88(8):601-6. doi: 10.1136/sextrans-2012-050584. Epub 2012 Jul 6.
To explore staff attitudes towards and experiences of the implementation of routine HIV testing in four healthcare settings in areas of high diagnosed HIV prevalence.
As part of the HINTS (HIV Testing in Non-traditional Settings) Study, routine offer of an HIV test to all 16-65-year-old patients was conducted for 3 months in an emergency department, an acute admissions unit, a dermatology outpatients department and a primary care practice. The authors conducted focus groups with staff at these sites before and after the implementation of testing. Transcriptions of focus groups were subject to thematic analysis.
Four major themes were identified: the stigma of HIV and exceptionalisation of HIV testing as a condition; the use of routine testing compared with a targeted strategy as a means of improving the acceptability of testing; the need for an additional skill set to conduct HIV testing; and the existence within these particular settings of operational barriers to the implementation of HIV testing. Specifically, the time taken to conduct testing and management of results were seen by staff as barriers. There was a clear change in staff perception before and after implementation of testing as staff became aware of the high level of patient acceptability.
The routine offer of HIV testing in general medical services is feasible, but implementation requires training and support for staff, which may be best provided by the local sexual health service.
探讨在高 HIV 发病率地区的四个医疗保健环境中，工作人员对实施常规 HIV 检测的态度和经验。
作为 HINTS（非传统环境中的 HIV 检测）研究的一部分，在急诊室、急性入院病房、皮肤科门诊和初级保健诊所对所有 16-65 岁的患者进行了为期 3 个月的常规 HIV 检测。作者在实施检测前后在这些地点进行了工作人员的焦点小组讨论。对焦点小组的转录进行了主题分析。
确定了四个主要主题：HIV 的耻辱感和 HIV 检测作为一种特殊情况的例外；将常规检测与靶向策略相结合作为提高检测可接受性的手段；进行 HIV 检测所需的额外技能；以及在这些特定环境中存在实施 HIV 检测的操作障碍。具体而言，工作人员认为进行检测和管理检测结果所需的时间是障碍。在实施检测前后，工作人员的看法发生了明显变化，因为他们意识到患者的接受程度很高。
在一般医疗服务中常规提供 HIV 检测是可行的，但实施需要为工作人员提供培训和支持，最好由当地的性健康服务提供。
