An overview of recent evidence on barriers and facilitators to HIV testing

Traversy, Gregory; Austin, Tricia; Ha, S; Timmerman, K; Gale-Rowe, M

doi:10.14745/ccdr.v41i12a02

Cited by 20 publications

(21 citation statements)

References 32 publications

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“…The two gaps in knowledge-underestimating the percentage of people living with HIV who are unaware of their HIV status and lack of awareness that HIV patients are frequently symptomatic during acute infection-along with half of participants reporting they did not offer HIV screening and testing as part of routine care, may result in missed opportunities for early diagnosis of HIV. A lack of perceived risk has been previously identified as a key barrier to HIV testing (11).…”

Section: Discussionmentioning

confidence: 99%

“…The survey was designed in consultation with evaluation, infectious disease and HIV content experts. The questions were developed based on previous PHAC surveys with similar objectives and from previous literature on survey design (6,(9)(10)(11)(12). The survey and study protocol were externally peer-reviewed for face validity by an infectious disease physician and an expert in evaluation.…”

Section: Survey Designmentioning

confidence: 99%

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Assessing uptake of national HIV screening and testing guidance—Part 2: Knowledge, comfort and practice

Traversy

Austin

Yau

et al. 2017

Canada Communicable Disease Report

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Background: The Public Health Agency of Canada's (PHAC) HIV Screening and Testing Guide (the Guide) provides guidance to health care providers regarding who, when and how often to screen for HIV. HIV screening and testing is important in meeting the Joint United Nations Programme on HIV/AIDS' (UNAIDS) 90-90-90 targets towards HIV elimination. Objective: To determine health care providers' levels of knowledge about and comfort with aspects of HIV testing, and to determine whether their HIV testing practices are consistent with the recommendations in the Guide. Methods: An open, anonymous online survey that included questions on knowledge, comfort and HIV testing practices was developed with stakeholders, validated and pre-tested. It was then disseminated to a convenience sample of health care providers across Canada between June and August 2016. Results: A total of 1,075 participants representing all Canadian provinces and territories responded to the survey, with the majority being nurses (54%) and physicians (12%). Overall, knowledge related to HIV testing was substantial, but 37% of respondents underestimated the percentage of people living with HIV in Canada who are unaware of their HIV status and only 32% of respondents knew that HIV patients are frequently symptomatic during the acute infection. Most participants were comfortable with HIV testing and approximately 50% reported offering HIV testing regularly. Conclusions: Although overall knowledge and practice were consistent with PHAC's HIV Screening and Testing Guide, some health care providers may underestimate the magnitude of undiagnosed HIV cases in Canada and may misinterpret the symptoms of acute HIV infection. While the amplitude of these results need to be interpreted in light of the convenience sample, addressing these knowledge gaps may facilitate earlier diagnosis of HIV among those who are unaware of their HIV status.

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Section: Discussionmentioning

confidence: 99%

Section: Survey Designmentioning

confidence: 99%

Assessing uptake of national HIV screening and testing guidance—Part 2: Knowledge, comfort and practice

Traversy

Austin

Yau

et al. 2017

Canada Communicable Disease Report

Self Cite

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“…So, although we have documented declining rates of new cases this does not mean the need for HIV care will decrease. And continued efforts are needed to reach the undiagnosed cases of HIV to decrease transmission (9).…”

Section: Discussionmentioning

confidence: 99%

HIV in Canada: 2009 to 2014

Tomas

Dhami

Houston

et al. 2015

CCDR

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Background: Between 1996 and 2008, the number of newly reported HIV cases in Canada fluctuated between approximately 2,100 and 2,700 cases per year. Objective: To describe the recent trends in new diagnoses of HIV in Canada between 2009 and 2014 by age group, sex, exposure category, race/ethnicity, and region, as well as the number of perinatally HIV-exposed infants. Methods: HIV data were compiled from two databases. The National HIV/AIDS Surveillance System is a passive surveillance system that gathers non-nominal data on a voluntary basis from all the provinces and territories of all cases that meet the national case definition, and includes data on age group, sex, race/ethnicity, country of birth, and exposure categories. The Canadian Perinatal HIV Surveillance Program is a sentinel-based surveillance system; non-nominal data is obtained through a national confidential survey completed by participating physicians. Results: Since 2009 the number of new HIV cases has slowly but steadily declined from 2,391 cases in 2009 to 2,044 in 2014, which is the lowest number of annual HIV cases seen in the last two decades. The largest proportion (32%) of new HIV cases continues to be diagnosed among those 30 to 39 years of age, but the proportion of cases diagnosed among those 50 years of age or over has increased from 15% in 2009 to slightly over 20% in 2014. Approximately 75% of newly diagnosed cases are males and 25% females. In males, the most common exposure category (60%) was men who have sex with men. In females, the most common exposure category (66%) was heterosexual contact followed by injection drug use (27%). Race/ethnicity varied by sex. In males, over 50% were White, 14% were Aboriginal and 13% Black. In females, 35% were Black, 35% were Aboriginal and 22% were White. There were regional variations in HIV rates across Canada. Between 2009 and 2014, the number of perinatally HIV-exposed infants varied between 200 and 249 but the percentage of perinatal treatment increased from 87% in 2009 to 97% in 2014. Conclusion: The annual number of reported HIV cases in Canada has been declining in recent years. The proportion of HIV-positive mothers receiving treatment has increased and the number of confirmed HIV-infected infants has decreased.

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“…The design was based on previous PHAC surveys with similar objectives, previous literature on survey design, factors that influence testing behaviour and known barriers and facilitators of testing (8)(9)(10)(11)(12). The survey and study protocol were externally peer-reviewed for face validity by an infectious disease physician and an expert in evaluation.…”

Section: Survey Designmentioning

confidence: 99%