MS #10337r1 text - Rapid Testing Article FINAL for Publication JGIM 07-14-11.pdf (93.66 kB)
Provider and Practice Characteristics Associated with Use of Rapid HIV Testing by General Internists
journal contributionposted on 2012-03-16, 00:00 authored by Michael G. Bass, P. Todd Korthuis, Joseph Cofrancesco Jr, Gail V. Berkenblit, Lynn E. Sullivan, Steve M. Asch, Philip G. Bashook, Marcia Edison, James M. Sosman, Robert L. Cook
Background. Rapid HIV testing could increase routine HIV testing. Most previous studies of rapid testing were conducted in acute care settings, and few described the primary care providers’ perspective. Objective – To identify characteristics of general internal medicine physicians with access to rapid HIV testing, and to determine whether such access is associated with differences in HIV-testing practices or perceived HIV-testing barriers. Design – Web-based cross-sectional survey conducted in 2009. Participants - 406 physician members of the Society of General Internal Medicine who supervise residents or provide care in outpatient settings. Main measures. Surveys assessed provider and practice characteristics, HIV-testing types, HIV-testing behavior, and potential barriers to HIV testing. Results. Among respondents, 15% had access to rapid HIV testing. In multivariable analysis, physicians were more likely to report access to rapid testing if they were non-white (OR 0.45, 95% CI 0.22, 0.91), had more years since completing training (OR 1.06, 95% CI 1.02, 1.10), practiced in the Northeastern US (OR 2.35; 95% CI 1.28, 4.32), or if their practice included a higher percentage of uninsured patients (OR 1.03; 95% CI 1.01, 1.04). Internists with access to rapid testing reported fewer barriers to HIV testing. More respondents with rapid than standard testing reported at least 25% of their patients received HIV testing (51% versus 35%, p =.02). However, access to rapid HIV testing was not significantly associated with the estimated proportion of patients receiving HIV testing within the previous 30 days (7.24% vs. 4.58%, p=.06). Conclusion. Relatively few internists have access to rapid HIV testing in outpatient settings, with greater availability of rapid testing in community-based clinics and in the Northeastern U.S. Future research may determine whether access to rapid testing in primary care settings will impact routinizing HIV testing.
This work was supported by a grant from the Centers for Disease Control (CDC grant number 1 U22 PS00551-02 HIV Prevention with National Medical Associations), in conjunction with the Society of General Internal Medicine, HIV/AIDS Task force. Dr. Sullivan was supported by the Robert Wood Johnson Foundation Physician Faculty Scholars Program during the conduct of this work. Drs. Bashook and Edison were supported by a grant from the Health Resources Services Administration for the Midwest AIDS Education and Training Center during the conduct of this work. Dr. Korthuis was supported by the National Institutes of Health, National Institute on Drug Abuse (K23 DA019809) during the conduct of this work.
Publisher StatementPost print version of article may differ from published version. The original publication is available at springerlink.com; DOI: 10.1007/s11606-011-1764-z.