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Researchers reported on two studies
at a poster session of IDWeek 2012, a joint meeting of the Infectious Disease
Society of America (IDSA), the Society for Health and Epidemiology of America
(SHEA), the HIV Medicine Association (HIVMA), and the Pediatric Infectious
Diseases Society (PIDS). The studies exposed medical practitioners’ reluctance
to ask patients to take the test as a major barrier to universal HIV testing,
which is recommended by national, state, and local institutions.
A study by Marelle Yehuda, MD, an
internal medicine resident at Lenox Hill Hospital, New York, and others
reviewed records of 134 patients admitted during June 2011 and identified 87
who met criteria for HIV screening. Only eight of these patients were asked
about HIV screening. Yehuda and colleagues surveyed medical residents to determine
their knowledge of HIV screening criteria and their attitudes toward screening.
The results showed that 81 percent were not familiar with the CDC
recommendation that all patients should be screened for HIV infection nor the
2010 New York State legislative mandate that required patients be offered
screening; 75 percent understood the difference between “opt in” and “opt out”
testing; 43 percent believed written consent was necessary for rapid testing;
and 38 percent did not know how to order the rapid HIV screening test.
The residents provided three reasons
for not pursuing HIV testing: they were too busy, thought the test not
clinically relevant, or believed the patient was not at risk. These results led
to the hospital implementing a series of interventions to improve the HIV
screening rate, including educating residents, reminders on electronic medical
records, and simplifying the test order form.
In another study at the University
of Chicago, Sara Bares, MD, found that doctors did not ask patients to take the
HIV test. A survey of 259 residents in a six-week period resulted in 162
responses (63 percent). Less than 32 percent of the residents in an outpatient
clinic asked patients about HIV screening, 24 percent working with in-patients
asked, and 16 percent in the emergency department asked. Many said that they
did not ask because they thought that patients would refuse. David Pitrak, MD,
chief of infectious diseases at the University of Chicago and senior
investigator in this study, commented that one reason physicians do not ask
patients to be tested for HIV is that the physicians may not be able to
properly counsel patients who test positive. Dr. Pitrak explained that at the
University of Chicago, only infectious disease staff members follow up on
positive test results. A coordinator finds the individuals who tests positive
to schedule their appointments.
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit:
http://www.friendsofaids.org.
TOGETHER WE REMAIN STRONG!
