title: Physician and nurse perspectives on implementation of universal adult HIV screening guidelines in the Indian health service: results of a randomized survey.
abstract: OBJECTIVE
  We sought to determine attitudes and needs among health care providers in the Indian Health Service toward implementing routine human immunodeficiency virus (HIV) screening among 13- to 64-year-olds as per Centers for Disease Control and Prevention (CDC) guidelines.
  
  
  METHODS
  We surveyed a random sample of Indian Health Service physicians and nurses by e-mail and telephone interview. A total of 205 eligible respondents (response rate = 70%) completed the survey.
  
  
  RESULTS
  A majority (58%) of respondents were familiar or somewhat familiar with the 2006 CDC guidelines on HIV screening for 13- to 64-year-olds. A proportion of respondents (43%) felt that community HIV prevalence was below the 0.1% threshold the CDC recommends to initiate screening. Respondents supported routine, rather than solely risk-based HIV testing (70%) and stated that HIV screening would be realistic in their health facility (51%). Respondents felt that they needed special qualification to offer an HIV test (49%) or to notify a patient of a "reactive" HIV test result (67%).
  
  
  CONCLUSIONS
  A majority of Indian Health Service physicians and nurses support the CDC HIV screening guidelines. Providers need more information and training on HIV screening guidelines, implementation strategies, and relevant state HIV regulations.
authors.affiliation: Division of Epidemiology and Disease Prevention, US Indian Health Service, Albuquerque, New Mexico 87110, USA. Brigg.Reilley@ihs.gov
authors.forename: Brigg
authors.initials: B
authors.lastname: Reilley
authors.forename: John T
authors.initials: JT
authors.lastname: Redd
authors.forename: Scott
authors.initials: S
authors.lastname: Giberson
authors.forename: Juanita K
authors.initials: JK
authors.lastname: Lee
authors.forename: Don
authors.initials: D
authors.lastname: Haverkamp
authors.forename: James
authors.initials: J
authors.lastname: Cheek
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D014481:United States; D016549:United States Indian Health Service; D055815:Young Adult