HIV Testing in an Urgent-Care Clinic

Treatment advances have the potential to curtail HIV incidence and seroprevalence, yet the full benefits are unrealized because many persons who are infected do not know their serostatus. The researchers undertook an intensive observational study of HIV testing and counseling in a large health maintenance organization's urgent-care clinic (UCC) for non-threatening illnesses and non-traumatic injuries to better understand the HIV testing process in a medical environment.

The researchers used multiple data collection strategies, including observation, semi-structured interviews and analyses of documents and policies, to identify key factors influencing HIV testing. They examined the relationships of physicians, nurses and physician's assistants with UCC patients.

HIV testing in the UCC setting was found to be highly variable. Some patients were questioned about their sexual risk histories, while others were not; some, but not others, were given HIV prevention materials. For those patients who did receive these components of testing, the content of both the risk assessment and the HIV counseling was different from patient to patient. The researchers said their findings highlight "the problematic nature" of providing HIV test results in a UCC.

"A number of implementation issues were found to be relevant to the new US [CDC] policy of making HIV testing a routine feature of medical care," the authors concluded. "The study results suggest the need for organisationally fine-tuned interventions designed to improve the process of testing patients for HIV in medical settings."

Back to other news for January 6, 2006