Barriers and Facilitators in Readiness to Adopt Rapid HIV Testing Among Healthcare Workers in Chile

Oral rapid HIV testing (ORT), which is an alternative to the Enzyme-linked Immunosorbent Assay (ELISA) for HIV, has the potential to help Chile meet its national HIV prevention goals of increased testing and early entry into treatment. This study examined individual factors affecting Chilean healthcare providers’ readiness to adopt ORT and their perceived comfort in performing the test. This study used a cross-sectional survey design. A total of 150 nurses, midwives, and physicians participated in the study, and they were all employed at four clinics of the University Católica de Chile health network in Santiago. The participants completed a self-administered survey that included questions about their demographic characteristics, attitudes towards and experience with evidence-based practice (EBP), and AIDS-related attitudes and beliefs, including HIV-related stigmatization, perceived importance of HIV testing, and perceived comfort performing rapid HIV tests. Results showed that providers had a mean Readiness to implement ORT score of 15.1 on a scale of 0-20, with higher scores indicating higher readiness. Educational background, Beliefs about evidence-based practice, Perceived comfort performing rapid HIV test (PCP-ORT), and Perceived importance of HIV testing explained 43.6% of the variance in readiness to adopt ORT. Perceived comfort performing rapid HIV test was the strongest predictor of Readiness to adopt ORT. Developed for this study, this scale asked about level of comfort in performing pre-test counseling, giving an oral test, giving a finger-prick test, giving a positive test and post-counseling, and giving a negative test and post-counseling. Results showed a mean score of 16.21 (range 0-20). Participants felt least comfortable with giving positive test results and providing appropriate post-test counseling to patients. Stigmatizing attitudes were negatively related to Perceived Comfort Performing ORT. This finding highlights the need to address HIV-related stigmatization among healthcare providers and to offer ORT training, focusing on giving positive test results so that they can be truly comfortable performing ORT. This is the first pre-implementation study in anticipation of the possible introduction of ORT in Chile, and the results can guide preparations for ORT implementation by identifying and addressing potential barriers related to individual provider readiness to implement ORT.