Abstract
BackgroundLate HIV diagnosis remains one of the challenges in combating the epidemic. Primary care providers play an important role in screening for HIV infection. Our study aims to evaluate the relationship between knowledge and barriers to HIV testing and screening outcomes. The impact of an education program for primary care providers, towards improving HIV testing and late diagnosis rates, is also assessed.MethodsA self-administered questionnaire that was developed within the framework of the European project OptTEST was used to examine HIV knowledge and barriers to HIV testing scores before and after being involved in an HIV education program. A quasi-experimental design with pre- and post-intervention measures was performed to investigate its impact. We performed multivariable logistic regression analysis to assess the relationship between variables for the HIV testing offer.ResultsA total of 20 primary care centers and 454 primary care staff were included. Baseline OptTEST results showed that more knowledgeable staff offered an HIV test more frequently (OR 1.07; CI 95% 1.01–1.13; p = 0.027) and had lower barrier scores (OR 0.89; CI 95% 0.77–0.95; p = 0.005). Nurses had lower scores in knowledge-related items (OR 0.28; CI 95% 0.17–0.46; p<0.001), but higher scores in barrier-related items than physicians (OR 3.28; CI 95% 2.01–5.46; p<0.001). Specific centers with more knowledgeable staff members had a significant association with a greater level of new HIV diagnosis rates (OR 1.61; CI 95% 1.04–2.49; p = 0.032). After the intervention, we found that 12 out of 14 individual questions showed improved scores. In the 6 months after the training program, we similarly found a higher HIV testing rate (OR 1.19; CI 1.02–1.42; p = 0.036).ConclusionsThis study highlights the association between knowledge and barriers to HIV testing, including HIV testing rates. It shows that it is possible to modify knowledge and reduce perceived barriers through educational programs, subsequently improving HIV screening outcomes.
Highlights
Spain is one of the European countries with the highest estimated number of people living with HIV, and it still has a high rate of new HIV diagnoses [1,2]
Baseline OptTEST results showed that more knowledgeable staff offered an HIV test more frequently and had lower barrier scores
Impact of an HIV education program for primary care providers achieve Europe’’ (ERDF) and partially funded by the RD12/0017/0017 project as part of the Plan Nacional R + D + I and cofinanced by ISCIIISubdireccion General de Evaluacion y el Fondo Europeo de Desarrollo Regional (FEDER), and partially supported by unrestrictional grants from Janssen Cilag supporting FOCO project developed by the Spanish AIDS Interdisciplinary Society (SEISIDA), VIIF and Gilead supporting DRIVE 01, and DRIVE through IRYCIS
Summary
Spain is one of the European countries with the highest estimated number of people living with HIV, and it still has a high rate of new HIV diagnoses [1,2]. Of an estimated 150,000 people living with HIV in Spain, 18% remain undiagnosed [3]. Primary care providers are required to perform different preventive care tasks to achieve better quality care, one of which is screening for HIV infection. There is a need to assess the primary care providers’ knowledge about HIV, and to better understand barriers to HIV testing, with the aim of contributing to a decrease in the number of undiagnosed people [14,15]. To achieve effective control of the HIV epidemic, medical education is necessary, including updated information to primary care providers [16]. Our study aims to evaluate the relationship between knowledge and barriers to HIV testing and screening outcomes. The impact of an education program for primary care providers, towards improving HIV testing and late diagnosis rates, is assessed
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