Recent study shows gaps in use of rapid HIV testing
Here are the take-home points
Investigators recently studied the scope of rapid HIV testing, finding surprisingly limited use in urban hospitals and HIV clinics in the United States.1,2,3
Here are some of their findings:
- Rapid HIV tests are provided infrequently in private, nonprofit, urban community settings and greater diffusion is needed.1
- There are low rates of rapid HIV testing even in labor and delivery and emergency departments, and although rates of rapid testing are increasing, they're still lower than ideal to meet federal recommendations.2
- HIV rapid tests are less likely to be used in the Western region of the U.S., including in California, says Laura M. Bogart, PhD, senior behavioral scientist for the Rand Corp. of Santa Monica, CA.
- The biggest barrier to implementing HIV testing is the translational barrier. Providers are unsure how to implement policies on HIV testing, and they don't know how to change current testing protocols to a rapid testing protocol, Bogart says.
- Translational barrier issues include maintaining quality assurance practices, integrating counseling protocols, learning testing protocols for resource-limited settings, and working within administrative and governmental constraints.3
- All medical settings, including ERs, cope with barriers of insufficient time, consent and counseling requirements, inadequate reimbursement, and competing priorities.3
- The actual cost of the rapid test kit did not appear to be a barrier; however the institutional cost of setting up new protocols was seen as a barrier, Bogart says.
- Organizations with more capacity and those with their own on-site labs were more likely to offer rapid tests, Bogart says.
- Organizations located in higher AIDS prevalence areas were more likely to do rapid testing, she adds.
References
- Bogart LM, Howerton D, Lange J, et al. Scope of rapid HIV testing in private nonprofit urban community health settings in the United States. Am J Pub Health. 2008;98(4):736-742.
- Bogart LM, Howerton D, Lange J, et al. Scope of rapid HIV testing in urban U.S. hospitals. Pub Health Rep. 2008;123:494-503.
- Bogart LM, Lange J, Becker K. Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals. AIDS Behav. 2008;10:1-6.
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