Centers for Disease Control and Prevention, Atlanta, GA, USA.
PLoS One. 2013;8(1):e51231. doi: 10.1371/journal.pone.0051231. Epub 2013 Jan 14.
In 2006, CDC recommended HIV screening as part of routine medical care for all persons aged 13-64 years. We examined adherence to the recommendations among a sample of HIV care providers in the US to determine if known providers of HIV care are offering routine HIV testing in outpatient settings. Data were from the CDC's Medical Monitoring Project Provider Survey, administered to physicians, nurse practitioners and physician assistants from June-September 2009. We assessed bivariate associations between testing behaviors and provider and practice characteristics and used multivariate regression to determine factors associated with offering HIV screening to all patients aged 13-64 years. Sixty percent of providers reported offering HIV screening to all patients 13 to 64 years of age. Being a nurse practitioner (aOR = 5.6, 95% CI = 2.6-11.9) compared to physician, age<39 (aOR = 1.9, 95% CI = 1.0-3.5) or 39-49 (aOR = 2.1, 95% CI = 1.4-3.3) compared with ≥50 years, and black race (aOR = 2.6, 95% CI = 1.2-6.0) compared with white race was associated with offering testing to all patients. Providers with low (aOR = 0.2, 95% CI = 0.1-0.3) or medium (aOR = 0.4, 95% CI = 0.2-0.6) HIV-infected patient loads were less likely to offer HIV testing to all patients compared with providers with high patient loads. Many providers of HIV care are still conducting risk-based rather than routine testing. We found that provider profession, age, race, and HIV-infected patient load were associated with offering HIV testing. Health care providers should use patient encounters as an opportunity to offer routine HIV testing to patients as outlined in CDC's revised recommendations for HIV testing in health care settings.
2006 年，疾病预防控制中心（CDC）建议将 HIV 筛查作为所有 13-64 岁人群常规医疗保健的一部分。我们检查了美国 HIV 护理提供者样本中对这些建议的遵守情况，以确定 HIV 护理的已知提供者是否在门诊环境中提供常规 HIV 检测。数据来自疾病预防控制中心的医疗监测项目提供者调查，该调查于 2009 年 6 月至 9 月期间对医生、护士从业者和医师助理进行了管理。我们评估了检测行为与提供者和实践特征之间的双变量关联，并使用多变量回归确定了与向所有 13-64 岁患者提供 HIV 筛查相关的因素。60%的提供者报告说向所有 13 至 64 岁的患者提供 HIV 筛查。与医生相比，护士从业者（aOR=5.6，95%CI=2.6-11.9）、年龄<39（aOR=1.9，95%CI=1.0-3.5）或 39-49（aOR=2.1，95%CI=1.4-3.3）相比，≥50 岁，以及黑人种族（aOR=2.6，95%CI=1.2-6.0）与白人种族相比，更有可能向所有患者提供检测。HIV 感染者人数低（aOR=0.2，95%CI=0.1-0.3）或中（aOR=0.4，95%CI=0.2-0.6）的提供者与 HIV 感染者人数高的提供者相比，更不可能向所有患者提供 HIV 检测。许多 HIV 护理提供者仍在进行基于风险的而不是常规检测。我们发现，提供者的专业、年龄、种族和 HIV 感染者人数与提供 HIV 检测有关。医疗保健提供者应利用患者就诊机会，按照疾病预防控制中心修订的医疗保健环境中 HIV 检测建议，向患者提供常规 HIV 检测。
