title: General internists' beliefs, behaviors, and perceived barriers to routine HIV screening in primary care.
abstract: The Centers for Disease Control and Prevention (CDC) recommends routine HIV screening in primary care but little is known about general internists' views of this practice. We conducted a national, cross-sectional, Internet-based survey of 446 general internists in 2009 regarding their HIV screening behaviors, beliefs, and perceived barriers to routine HIV screening in outpatient internal medicine practices. Internists' awareness of revised CDC guidelines was high (88%), but only 52% had increased HIV testing, 61% offered HIV screening regardless of risk, and a median 2% (range 0-67%) of their patients were tested in the past month. Internists practicing in perceived higher risk communities reported greater HIV screening. Consent requirements were a barrier to screening, particularly for VA providers and those practicing in states with HIV consent statutes inconsistent with CDC guidelines. Interventions that promote HIV screening regardless of risk and streamlined consent requirements will likely increase adoption of routine HIV screening in general medicine practices.
authors.affiliation: Department of Medicine and Public Health, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239-3098, USA. korthuis@ohsu.edu
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Gail V
authors.initials: GV
authors.lastname: Berkenblit
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cook
authors.forename: Michael
authors.initials: M
authors.lastname: Bass
authors.forename: Philip G
authors.initials: PG
authors.lastname: Bashook
authors.forename: Marcia
authors.initials: M
authors.lastname: Edison
authors.forename: Steve M
authors.initials: SM
authors.lastname: Asch
authors.forename: James M
authors.initials: JM
authors.lastname: Sosman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002487:Centers for Disease Control and Prevention, U.S.; D003430:Cross-Sectional Studies; D058005:General Practitioners / Q000523:psychology*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis*; D006297:Health Services Accessibility; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012955:Societies, Medical; D014481:United States