基层医疗诊所中普遍开展HIV筛查的错失机遇。
Missed Opportunities for Universal HIV Screening in Primary Care Clinics.
作者信息
Hudson Angela L, Heilemann Marysue V, Rodriguez Michael
机构信息
School of Nursing, University of California, Los Angeles, 700 Tiverton Avenue, Los Angeles, CA 90095, USA.
出版信息
J Clin Med Res. 2012 Aug;4(4):242-50. doi: 10.4021/jocmr1014w. Epub 2012 Jul 20.
BACKGROUND
The Centers for Disease Control and Prevention (CDC) has reported that the number of new cases of HIV infection has been underreported annually by at least 40,000 cases. In 2006, the CDC recommended that voluntary HIV counseling and testing (VCT) was given to all patients aged 13 to 64 years in ambulatory care settings. The purpose of this qualitative study was to explore primary care providers' (PCP) perspectives on and experiences of facilitators and barriers to offering VCT as part of annual screening.
METHODS
This was a descriptive, exploratory study where fifteen primary care providers were individually interviewed. Only community-based primary care providers were interviewed, and no obstetrician/gynecologists were enrolled, as VCT is standard of care in that specialty.
RESULTS
Barriers included doubts about the CDC recommendation, time constraints, fear, and assumptions about age and marital status. Facilitators included normalizing HIV testing and the availability of resources and training. PCPs' role as an advocate and their professional style had the paradoxical potential of being both a barrier and a facilitator to VCT. Providers' ability to connect patients to community resources was linked to their persistence and experience.
CONCLUSIONS
Findings suggest more effort is needed by PCPs to facilitate HIV counseling and testing more frequently to their ambulatory care patients.
背景
美国疾病控制与预防中心（CDC）报告称，每年新增艾滋病病毒（HIV）感染病例数至少少报4万例。2006年，CDC建议在门诊护理环境中，为所有13至64岁的患者提供自愿HIV咨询和检测（VCT）。这项定性研究的目的是探讨初级保健提供者（PCP）对作为年度筛查一部分提供VCT的促进因素和障碍的看法及经历。
方法
这是一项描述性探索性研究，对15名初级保健提供者进行了单独访谈。仅访谈了社区初级保健提供者，未纳入产科医生/妇科医生，因为VCT是该专业的标准护理。
结果
障碍包括对CDC建议的怀疑、时间限制、恐惧以及对年龄和婚姻状况的假设。促进因素包括使HIV检测常态化以及资源和培训的可获得性。PCP作为倡导者的角色及其专业风格有可能同时成为VCT的障碍和促进因素。提供者将患者与社区资源联系起来的能力与他们的坚持和经验有关。
结论
研究结果表明，PCP需要付出更多努力，以便更频繁地为其门诊护理患者提供HIV咨询和检测。
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