HIV testing in an urgent-care clinic.
BACKGROUND
Early detection of HIV is increasingly important in light of advances in HIV research and treatment. Although treatment advances offer the potential to curtail HIV incidence and seroprevalence, the full benefits remain unrealised because many infected individuals remain unaware of their serostatus. An intensive observational study of HIV testing and counselling was undertaken in a large health maintenance organisation's urgent-care clinic (UCC) for non-threatening illnesses and non-traumatic injuries in order to better understand the HIV testing process in a medical setting.


METHODS
Multiple data collection strategies, including observation, semi-structured interviews and document and policy analyses, were used in order to identify key factors influencing HIV testing. The study examined physicians', nurses' and physician's assistants' relationships with patients in the UCC.


RESULTS
It was found that HIV testing in the UCC is highly variable because some patients are asked about their sexual risk histories and given HIV prevention education materials and others are not. Moreover, for those patients who do receive these components of testing, the content of both the risk assessments and HIV prevention counselling varies from patient to patient. Findings also highlight the problematic nature of providing HIV test results in an UCC.


CONCLUSIONS
A number of implementation issues were found to be relevant to the new US Centers for Disease Control and Prevention (CDC) policy of making HIV testing a routine feature of medical care. The study results suggest the need for organisationally fine-tuned interventions designed to improve the process of testing patients for HIV in medical settings.
Murphy
Keith
K
Department of Anthropology, University of California, Los Angeles, CA, USA.
Grusky
Oscar
O
Roberts
Kathleen Johnston
KJ
Swanson
Aimee-Noelle
AN
D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001294:Attitude to Health; D003376:Counseling / Q000458:organization & administration*; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000458:organization & administration; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D014481:United States