Study: Normalizing HIV Testing in a Busy Urban Sexually Transmitted Infections Clinic

In the current study, the authors reported on their experience with making rapid-result HIV testing a routine procedure in a large sexually transmitted infection (STI) clinic. Increased awareness of HIV serostatus is a key part of HIV prevention efforts, and routine HIV testing in clinical settings has been identified as a priority.

A series of logistical changes were implemented to enhance acceptance of HIV testing. These included the introduction of rapid-result testing, changes in the sequences of clinical procedures, and an opt-out consent process. The effect of these changes on HIV testing was measured by the ratio of HIV testing and syphilis RPR testing, with the latter defined as the "gold standard" of routine testing in an STI clinic setting.

"Over time and in relationship to the introduction of clinic changes, the HIV/RPR ratio increased from 0.79 at baseline to 0.96 after full implementation," the authors reported, while overall HIV positivity rates "did not vary significantly over time."

"After the introduction of several changes in clinic procedures, we experienced an increase in HIV testing uptake relative to routine syphilis testing," the authors concluded. "In STI clinics, HIV testing can be made as normal as other routine STI testing."

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