Factors Affecting Clinician Educator Encouragement of Routine HIV Testing Among Trainees

Berkenblit, Gail; Sosman, James M.; Bass, Michael; Gebrekristos, Hirut T.; Cofrancesco, Joseph; Sullivan, Lynn E.; Cook, Robert L.; Edison, Marcia; Bashook, Philip G.; Korthuis, P. Todd

doi:10.1007/s11606-012-1985-9

Cited by 18 publications

(27 citation statements)

References 30 publications

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“…However, our response rate of 53.2% was higher than other studies surveying physician practices of HIV screening. (10, 18, 25, 26) Furthermore, non-responders were similar to responders with respect to provider type and sex, although non-responders were more likely to practice in suburban areas. Another limitation of this study is that we surveyed providers affiliated with one pediatric primary care network.…”

Section: Discussionmentioning

confidence: 90%

Pediatric Primary Care Provider Practices, Knowledge, and Attitudes of Human Immunodeficiency Virus Screening among Adolescents

Goyal¹,

Dowshen²,

Mehta³

et al. 2013

The Journal of Pediatrics

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Objectives To evaluate pediatric primary care provider (PCP) HIV screening practices, knowledge, and attitudes. Study design Anonymous cross-sectional, internet-based survey of pediatric PCPs from 29 primary care practices. Survey items assessed current HIV screening practices and knowledge, attitudes, and perceived barriers towards screening. Provider demographics and practice characteristics were analyzed for associations with screening through logistic regression. Results Of 190 PCPs, there were 101 evaluable responses (response rate: 53.2%). PCPs reported a screening rate for HIV of 39.6% (“most” or “all of the time”) during routine adolescent visits compared with violence (60.4%), substance abuse (92.1%), and depression (94.1%) (p<0.001). Less than 10% of PCPs correctly answered questions related to CDC and state HIV screening recommendations. Of 20 potential HIV screening barriers assessed, mean number of reported barriers was 4.8 (SD +/− 2.9); with most concerns related to confidentiality, time for counseling, and follow up. In a multivariable model, the only factor significantly associated with HIV screening “most” or “all of the time” during routine adolescent visits was urban practice site (adjusted odds ratio 9.8, 95% CI 2.9, 32.9). Provider type, sex, years since training, HIV screening guideline knowledge, and endorsing ≤5 barriers were not associated with HIV screening. Conclusions Although providers practicing in urban areas were more likely to report screening adolescents for HIV than those in suburban areas, overall self-reported screening rates were low, and several barriers were identified commonly. Future interventions should target increasing providers’ knowledge and addressing concerns about confidentiality, requirements and counseling time, and follow-up of results.

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Section: Discussionmentioning

confidence: 90%

Pediatric Primary Care Provider Practices, Knowledge, and Attitudes of Human Immunodeficiency Virus Screening among Adolescents

Goyal¹,

Dowshen²,

Mehta³

et al. 2013

The Journal of Pediatrics

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“…Although prior research has shown that for many conditions and patient populations, clinician adherence to clinical guidelines is suboptimal, 2, 4, 33, 43 this is the first study to present an extensive evaluation of longitudinal data on receipt of guideline-concordant OT. Three of the four studies that have been published in this area have focused on a subset of OT patients, 36, 37, 42 and all involved regional data.…”

Section: Discussionmentioning

confidence: 98%

Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans

Gaither

Goulet

Becker

et al. 2014

The Journal of Pain

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Whether patients receive guideline-concordant opioid therapy (OT) is largely unknown and may vary based on provider and patient characteristics. We assessed the extent to which HIV-infected and uninfected patients initiating long-term (≥90-days) OT received care concordant with American Pain Society/American Academy of Pain Medicine and Department of Veterans Affairs/Department of Defense guidelines by measuring receipt of 17 indicators during the first 6 months of OT. Of 20,753 patients, HIV-infected patients (n= 6,604) were more likely than uninfected patients to receive a primary care provider (PCP) visit within 1-month (52.0% vs. 30.9%) and 6-months (90.7% vs. 73.7%) and urine drug tests (UDTs) within 1-month (14.8% vs. 11.5%) and 6-months (19.5% vs. 15.4%; all p < .001). HIV-infected patients were also more likely to receive OT concurrent with sedatives (24.6% vs. 19.6%) and an untreated substance use disorder (SUD; 21.6% vs. 17.2%). Among both patient groups, only modest changes in guideline-concordance were observed over time: UDTs and OT concurrent with untreated SUDs increased, while sedative co-prescriptions decreased (all p for trend < .001). Over a 10-year period, on average, patients received no more than 40% of recommended indicators. OT guideline-concordant care is rare in primary care, varies by patient/provider characteristics, and has undergone few changes over time. Perspective The promulgation of OT clinical guidelines has not resulted in substantive changes over time in OT management, which falls well short of the standard recommended by leading medical societies. Strategies are needed to increase the provision of OT guideline-concordant care for all patients.

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“…Faced with the high number of patients with HIV/AIDS, it has become necessary to adapt the attitudes of health professionals and students to reality [1][2][3][4][5] . From 2012 to mid-2013, 35.3 million people worldwide were reported to be living with AIDS 6 , 718,000 alone in…”

Section: Introductionmentioning

confidence: 99%

Knowledge, risk perception and attitudes of Dentistry students with regard to HIV/AIDS

Magalhães

Oliveira

Prado

2015

RGO, Rev. Gaúch. Odontol.

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Factors Affecting Clinician Educator Encouragement of Routine HIV Testing Among Trainees

Cited by 18 publications

References 30 publications

Pediatric Primary Care Provider Practices, Knowledge, and Attitudes of Human Immunodeficiency Virus Screening among Adolescents

Pediatric Primary Care Provider Practices, Knowledge, and Attitudes of Human Immunodeficiency Virus Screening among Adolescents

Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans

Knowledge, risk perception and attitudes of Dentistry students with regard to HIV/AIDS

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