title: Perspectives of health care provider regarding TB-HIV referral strategy and non-uptake of HIV testing in Delhi - A qualitative study.
abstract: BACKGROUND
  DOTS provider and medical officer play an integral role in implementation of RNTCP. Understanding provider perspectives is an integral component of evaluating programme to improve services to identify the areas for quality improvement and universal HIV testing among TB patients.
  
  
  OBJECTIVE
  To describe the perception of health care providers regarding TB-HIV referral strategy and reasons for non-uptake of HIV testing.
  
  
  METHODS
  A qualitative study was undertaken at DOTS cum microscopic centre of TB-Chest clinic of Lok Nayak Hospital and DOTS cum microscopic centre of rural area of west Delhi. In-depth interview of DOTS provider and medical officer in-charge at DOTS centre was conducted. A topic outline guide used to assess the perception of study subjects. Thematic analysis of qualitative data was done.
  
  
  RESULTS
  The source of knowledge regarding HIV testing among DOTS providers were training and monthly review meetings. All the study participants knew the rational of HIV testing and the consequences of not being tested and are highly motivated for referring the patients for HIV testing at the earliest. Some of the barriers to HIV testing reported by the health care providers were lack of awareness, associated stigma, long distance travel by the patients and non-availability of HIV testing kits.
  
  
  CONCLUSIONS
  Health care providers were motivated for implementation of the strategy. Barriers to HIV TB testing strategy should be addressed.
authors.affiliation: Assistant Professor, MVJ Medical College and Research Hospital, Hoskote, Bangalore 562114, India. Electronic address: drvish2004@gmail.com.
authors.forename: V C
authors.initials: VC
authors.lastname: Soyam
authors.affiliation: Director Professor, Community Medicine Department, Maulana Azad Medical College, New Delhi, India.
authors.forename: N
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Assistant Director, National Centre for Disease Control, New Delhi, India.
authors.lastname: Jyoti Das
authors.affiliation: Senior Resident, Vardhaman Mahavir Medical College and Safderjang Hospital, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Boro
authors.affiliation: Senior Resident, Community Medicine Department, Maulana Azad Medical College, New Delhi, India.
authors.forename: Charu
authors.initials: C
authors.lastname: Kohli
authors.affiliation: Chief Medical Officer (SAG), DTO and In Charge Chest Clinic, Lok Nayak Hospital, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Khanna
authors.affiliation: Director Professor, Community Medicine Department, Maulana Azad Medical College, New Delhi, India.
authors.forename: G S
authors.initials: GS
authors.lastname: Meena
mesh_terms: D015492:AIDS Serodiagnosis; D001291:Attitude of Health Personnel; D023801:Directly Observed Therapy; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D007194:India; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D012017:Referral and Consultation; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
keywords: DOTS provider; HIV testing; In depth interview