Provider and Practice Characteristics Associated with Use of Rapid HIV Testing by General Internists

  • Michael G. Bass
  • P. Todd Korthuis
  • Joseph CofrancescoJr
  • Gail V. Berkenblit
  • Lynn E. Sullivan
  • Steve M. Asch
  • Philip G. Bashook
  • Marcia Edison
  • James M. Sosman
  • Robert L. Cook
Original Research

Abstract

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

A total of 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 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 = 0.02). 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 = 0.06).

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 US. Future research may determine whether access to rapid testing in primary care settings will impact routinizing HIV testing.

KEY WORDS

HIV testing rapid HIV testing HIV/AIDS general internal medicine physicians HIV prevention medical practice setting 

Notes

Acknowledgements

We want to thank our colleagues at the Society for General Internal Medicine for responding to our survey, and providing thoughtful feedback. We appreciate the funding we received from the Centers for Disease Control and Prevention, and our respective agencies, which allowed us to carry on this work. We wish to especially thank Leslie Dunne, our SGIM project manager, who facilitated this effort to completion.

Sources of Support

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.

Disclaimer

The contents of this publication are solely the responsibility of the authors and do not necessarily represent the views of the funding agencies, the US government, or the Department of Veterans Affairs.

Conflict of Interest

None disclosed.

Supplementary material

11606_2011_1764_MOESM1_ESM.pdf (35 kb)
ESM 1 (PDF 35 kb)

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Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Michael G. Bass
    • 1
  • P. Todd Korthuis
    • 2
  • Joseph CofrancescoJr
    • 3
  • Gail V. Berkenblit
    • 3
  • Lynn E. Sullivan
    • 4
  • Steve M. Asch
    • 5
  • Philip G. Bashook
    • 1
  • Marcia Edison
    • 1
  • James M. Sosman
    • 6
  • Robert L. Cook
    • 7
  1. 1.Department of Medical EducationUniversity of Illinois College of MedicineChicagoUSA
  2. 2.Departments of Medicine and Public Health & Preventive MedicineOregon Health and Science UniversityPortlandUSA
  3. 3.Department of MedicineJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of Internal MedicineYale University School of MedicineNew HavenUSA
  5. 5.VA Greater Los Angeles Healthcare SystemDavid Geffen School of Medicine at UCLALos AngelesUSA
  6. 6.Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  7. 7.Departments of Epidemiology and MedicineUniversity of FloridaGainesvilleUSA

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