title: Why Physicians Don't Ask: Interpersonal and Intrapersonal Barriers to HIV Testing-Making a Case for a Patient-Initiated Campaign.
abstract: In 2006, the US Centers for Disease Control and Prevention recommended HIV testing for all adolescents and adults aged 13 to 64 in health care settings with a HIV prevalence of at least 0.1%. However, 55% of US adults have never been tested and therefore do not know their HIV status. To understand suboptimal HIV testing rates, this study sought to illuminate interpersonal and intrapersonal physician barriers to HIV testing. One hundred and eighty physicians from health centers in Houston completed a survey based on Cabana's Knowledge, Attitudes and Behaviors model. One-third of the physicians faced at least 1 interpersonal barrier to HIV testing, such as a difference in age or language. Many (41%) physicians faced at least 1 intrapersonal barrier, such as believing their patients would be feeling uncomfortable discussing HIV. Notably, 71% of physicians would prefer their patients ask for the test. A patient-engaging campaign may be an innovative solution to increasing HIV testing and reducing the number of undiagnosed persons.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: Monisha
authors.initials: M
authors.lastname: Arya
authors.affiliation: Rice University, Houston, TX, USA Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Sajani
authors.initials: S
authors.lastname: Patel
authors.affiliation: Rice University, Houston, TX, USA School of Medicine, Baylor College of Medicine, Houston, TX, USA disha.kumar@bcm.edu.
authors.forename: Disha
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Rice University, Houston, TX, USA School of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Micha Yin
authors.initials: MY
authors.lastname: Zheng
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kallen
authors.affiliation: Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Street
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Kasisomayajula
authors.initials: K
authors.lastname: Viswanath
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Giordano
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: HIV testing; patient-centered campaign; patient–physician communication; physician barriers