Abstract
BackgroundSince 2009, HIV mass screening of the 15–70-year-old general population in low-risk situations has been recommended in France. This, not yet implemented, untargeted screening would be cost-effective with a positive impact on public health. No previous studies had interrogated primary care patients about it. This study aimed at exploring perceptions of patients attending general practitioner’s on HIV mass screening and at identifying barriers to its implementation.MethodsWe conducted a qualitative study through semi-structured individual interviews. Participants were recruited according to age, gender and location of their physician’s practice. Data analysis was based on triangulation by two researchers.ResultsTwenty-four interviews were necessary to obtain data saturation. HIV transmission was mostly associated with sexual intercourse; main barriers stemming from the screening were related to sexuality, often seen as questioning spouse’s faithfulness. It could interfere with religiosity, implying an upsetting perception of sexuality among the elderly. Patients’ beliefs and perceptions regarding HIV/AIDS, the fear to be screened and difficulties to talk about sexuality were other barriers.ConclusionTo our knowledge, no studies had previously interrogated primary care patients about barriers to HIV mass screening in France. Although relevance of this untargeted screening is debated in France, our results could be helpful to a better understanding of patients’ attitudes toward this and to an outstanding contribution to reduce the number of new cases of HIV contamination.
Highlights
Since 2009, human immunodeficiency virus (HIV) mass screening of the 15–70-year-old general population in low-risk situations has been recommended in France
Barriers to the HIV mass screening related to sexuality Most of interviewed patients associated HIV transmission with sexual relations, so they considered that the screening inevitably questioned their spouse’s fidelity: “we cannot always have suspicions and get screened every 6 months”
Our results provide a better insight into barriers to the HIV mass screening from the patients point of view and clarify their beliefs and perceptions
Summary
Since 2009, HIV mass screening of the 15–70-year-old general population in low-risk situations has been recommended in France. This, not yet implemented, untargeted screening would be cost-effective with a positive impact on public health. In 2004, according to the French Institute for Public Health Surveillance (Institut de veille sanitaire, InVS), 47% of adults were not aware of being HIV-positive at the time of the diagnosis of AIDS, 46% of them were heterosexuals born in France [5]. Since 2009, mass screening of the low-risk 15–70year-old general population has been recommended. This screening would be beneficial in terms of public health and cost-effective [7] a recent French study questioned its utility [8]. Diagnosis of HIV infection would have an individual and collective positive impact [9,10,11,12,13,14]
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