title: Provider and practice characteristics associated with use of rapid HIV Testing by general internists.
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.
  
  
  METHODS
  Web-based cross-sectional survey conducted in 2009.
  
  
  METHODS
  A total of 406 physician members of the Society of General Internal Medicine who supervise residents or provide care in outpatient settings.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bass
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
authors.forename: Gail V
authors.initials: GV
authors.lastname: Berkenblit
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
authors.forename: Steve M
authors.initials: SM
authors.lastname: Asch
authors.forename: Philip G
authors.initials: PG
authors.lastname: Bashook
authors.forename: Marcia
authors.initials: M
authors.lastname: Edison
authors.forename: James M
authors.initials: JM
authors.lastname: Sosman
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cook
mesh_terms: D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States