title: Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney.
abstract: OBJECTIVE
  Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics.
  
  
  METHODS
  Service providers were surveyed immediately after training in RHT and again 6-12 months later. Differences in mean scores between survey rounds were assessed via t-tests, with stratification by profession and the number of tests performed.
  
  
  RESULTS
  RHT was rated as highly acceptable among staff at baseline and acceptability scores improved between survey rounds. Belief in being sufficiently skilled and experienced to perform RHT (P = 0.004) and confidence in the delivery of nonreactive results increased (P = 0.007), while the belief that RHT was disruptive declined (P = 0.001). Acceptability was higher for staff who had performed a greater number of tests regarding comfort with their role in RHT (P = 0.004) and belief that patients were satisfied with RHT (P = 0.007). Compared with nurses, doctors had a stronger preference for a faster rapid test (P = 0.027) and were more likely to agree that RHT interfered with consultations (P = 0.014).
  
  
  CONCLUSIONS
  Differences in responses between professions may reflect differences in staff roles, the type of patients seen by staff and the model of testing used, all of which may affect the number of tests performed by staff. These findings may inform planning for how best to implement RHT in clinical services.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Short Street Sexual Health Centre, St George Hospital, Kogarah, NSW, Australia.
authors.forename: D P
authors.initials: DP
authors.lastname: Conway
authors.forename: R
authors.initials: R
authors.lastname: Guy
authors.forename: A
authors.initials: A
authors.lastname: McNulty
authors.forename: D L
authors.initials: DL
authors.lastname: Couldwell
authors.forename: S C
authors.initials: SC
authors.lastname: Davies
authors.forename: D E
authors.initials: DE
authors.lastname: Smith
authors.forename: P
authors.initials: P
authors.lastname: Keen
authors.forename: P
authors.initials: P
authors.lastname: Cunningham
authors.forename: M
authors.initials: M
authors.lastname: Holt
mesh_terms: D001291:Attitude of Health Personnel; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis*; D019538:Health Care Surveys; D006268:Health Facilities; D006716:Homosexuality; D006801:Humans; D008297:Male; D008403:Mass Screening; D009517:New South Wales / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012725:Sexual Behavior; D011795:Surveys and Questionnaires
keywords: provider acceptability; rapid HIV testing; sexual health clinics; staff attitudes