School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, 573H Nursing Building, Birmingham, AL, 35294, USA.
Division of Infections Disease, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
AIDS Behav. 2019 Apr;23(4):1062-1072. doi: 10.1007/s10461-018-02385-5.
Although CDC guidelines call for universal, "opt-out" HIV testing, barriers to testing continue to exist throughout the United States, with the rural South particularly vulnerable to both HIV infection and decreased awareness of status. Therefore, the objectives of this study were to evaluate uptake of "opt-out" HIV testing and barriers to testing within the primary care setting in the South. A concurrent triangulation design guided the collection of quantitative data from patients (N = 250) and qualitative data from providers (N = 10) across three primary health clinics in Alabama. We found that 30% of patients had never been tested for HIV, with the highest ranked barrier among patients being perceived costs, access to specialty care, and not feeling at risk. Significant differences existed in perceived barriers between patients and providers. Increased provider-patient engagement and the routine implementation of "opt-out" HIV testing would effectively reveal and mitigate barriers to testing, thus, increasing awareness of status.
虽然疾控中心的指南呼吁进行普遍的“选择退出”艾滋病毒检测，但在美国各地，检测仍然存在障碍，农村南部地区尤其容易受到艾滋病毒感染和对感染状况认识不足的影响。因此，本研究的目的是评估南部初级保健环境中“选择退出”艾滋病毒检测的采用情况和检测障碍。本研究采用同时三角测量设计，从阿拉巴马州的三家初级保健诊所收集了患者（n=250）的定量数据和提供者（n=10）的定性数据。我们发现，30%的患者从未接受过艾滋病毒检测，患者认为检测的主要障碍是检测费用、获得专科护理的机会以及自我感觉没有感染风险。患者和提供者之间在感知障碍方面存在显著差异。增加医患互动和常规实施“选择退出”艾滋病毒检测将有效地揭示和减轻检测障碍，从而提高对感染状况的认识。
