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Canadian Journal of Public Health

, Volume 101, Issue 4, pp 294–299 | Cite as

Patterns of HIV Testing Among Ontario Physicians

  • Claudia Rank
  • Robert S. RemisEmail author
  • Swantee Carol
  • Keyi Wu
Quantitative Research
  • 1 Downloads

Abstract

Objective

HIV testing is important for HIV prevention and control. Nevertheless, approximately 35% of HIV infections in Ontario remain undiagnosed. We examined patterns of HIV testing among physicians to determine provider-related factors associated with HIV testing in Ontario.

Methods

Providers identified from HIV test requisitions submitted to the Ontario Public Health Laboratory in 2006 were linked to a database of Ontario physicians using probabilistic matching. We examined HIV testing frequency by demographic characteristics and physician specialty. In multivariate logistic regression, we assessed factors associated with high testing frequency (20+ tests).

Results

12,477 physicians (59.3% of Ontario physicians) prescribed at least one HIV test in 2006; the proportion was highest in Central East/other (72.4%) and Northern (69.4%) regions compared to others (53.7-58.7%), and highest among the most recent graduates (68.4% versus 59.0% among earlier graduates). A substantial proportion of physicians in family medicine/general practice (83.6%), obstetrics/gynecology (82.1%) and internal medicine (47.7%) prescribed HIV testing. Overall, most physicians (67.5%) prescribed fewer than 20 tests. High testing frequency was significantly associated with practice in Toronto (AOR 2.95), Central East/other (AOR 2.02), or Ottawa region (AOR 2.28), and specialty in family medicine/general practice (AOR 11.47), obstetrics/gynecology (AOR 6.31) or internal medicine (AOR 1.37). Physician sex and graduation country were not associated with high testing in multivariate regression. Of 361,609 tests, 1,048 (0.29%) were HIV-positive; 436 physicians (3.5%) had at least one HIV-positive result.

Conclusion

HIV testing among Ontario physicians varied substantially by health region, graduation year and specialty. These factors should be considered when delivering continuing medical education on HIV testing.

Key words

HIV serodiagnosis physicians Ontario data linkage 

Résumé

Objectif

Le test de sérodiagnostic du VIH est important pour prévenir et enrayer ce virus. Malgré cela, environ 35 % des infections à VIH en Ontario ne sont pas diagnostiquées. Nous avons examiné les schémas de sérodiagnostic du VIH par les médecins afin de déterminer les facteurs associés aux dispensateurs de soins dans le sérodiagnostic du VIH en Ontario.

Méthode

Les dispensateurs, identifiés à partir des demandes de test VIH présentées au Laboratoire central de santé publique de l’Ontario en 2006, ont été maillés par couplage probabiliste à une base de données de médecins ontariens. Nous avons examiné la fréquence de sérodiagnostic du VIH selon le profil démographique et la spécialité des médecins. Au moyen d’une analyse de régression logistique multivariée, nous avons évalué les facteurs associés à une fréquence de sérodiagnostic élevée (20 tests et plus).

Résultats

12,477 médecins (59,3 % des médecins ontariens) ont prescrit au moins un test VIH en 2006; la proportion était plus élevée dans la région du Centre-Est/autre (72,4 %) et dans la région du Nord (69,4 %) que dans les autres régions (53,7 à 58,7 %), et plus élevée chez les diplômés récents que chez les diplômés de plus longue date (68,4 % c. 59,0 %). Une proportion importante de praticiens de la médecine de famille/médecine générale (83,6 %), de l’obstétrique/gynécologie (82,1 %) et de la médecine interne (47,7 %) a prescrit des tests VIH. Globalement, la plupart des médecins (67,5 %) ont prescrit moins de 20 tests. Il y avait une corrélation significative entre une fréquence de sérodiagnostic élevée et l’exercice de la médecine à Toronto (RCa = 2,95), la région du Centre-Est/autres (RCa = 2,02), ou la région d’Ottawa (RCa = 2,28), et les spécialités de la médecine de famille/médecine générale (RCa = 11,47), de l’obstétrique/gynécologie (RCa = 6,31) ou de la médecine interne (RCa = 1,37). Le sexe des médecins et leur pays de diplomation n’étaient pas associés à des niveaux élevés de sérodiagnostic selon l’analyse de régression multivariée. Sur 361 609 tests VIH, 1 048 (0,29 %) étaient séropositifs; 436 médecins (3,5 %) ont commandé au moins un test VIH s’étant révélé séropositif.

Conclusion

Le sérodiagnostic du VIH par les médecins ontariens varie considérablement selon la région sanitaire, l’année de diplomation et la spécialité. Il faudrait tenir compte de ces facteurs dans la formation médicale continue sur le sérodiagnostic du VIH.

Mots clés

sérodiagnostic du VIH médecins Ontario maillage de données 

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Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Claudia Rank
    • 1
  • Robert S. Remis
    • 2
    Email author
  • Swantee Carol
    • 1
  • Keyi Wu
    • 1
  1. 1.Ontario Public Health LaboratoryOntario Agency for Health Protection and PromotionTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

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