TY - JOUR
T1 - Identifying key elements to inform HIV-testing interventions for primary care in Belgium
AU - Apers, Hanne
AU - Nöstlinger, Christiana
AU - Van Beckhoven, Dominique
AU - Deblonde, Jessika
AU - Apers, Ludwig
AU - Verheyen, Katleen
AU - Loos, Jasna
AU - HERMETIC Study Group
AU - Ķīvīte-Urtāne, Anda
A2 - Kaupe, Ruta
A2 - Lemsalu, Liis
A2 - Marty, Lise
A2 - Michels, David
A2 - Supervie, Virginie
A2 - Rojas Castro, Daniela
A2 - Upmace, Inga
N1 - © The Author(s) 2019. Published by Oxford University Press.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - General practitioners (GPs) play a key role in reducing the hidden HIV-epidemic, but many diagnostic opportunities are missed in primary care. This study aimed at informing the development of an HIV-testing intervention for GPs in Flanders (Belgium) using formative research with a participatory approach. Through the active involvement of an advisory board and 16 group discussions with 122 Flemish GPs, GPs' current HIV-testing practices and perceived practical relevance of 2 distinct HIV-testing strategies (i.e. provider-initiated testing of key populations and indicator condition-based testing) were explored in terms of their relevance and feasibility in routine primary care. Self-reported HIV-testing practices revealed that most tests performed were patient-initiated, pretest counseling was rarely done, and post-test counseling was offered mainly for patients with an HIV-diagnosis. GPs reported multiple barriers to provider-initiated HIV-testing, i.e. personal discomfort, fear of offending their patient, limited knowledge of benefits of early HIV-diagnosis, misconceptions about HIV-risks, lack of guidelines and time. Difficulties to identify patient's sexual orientation or ethical concerns were mentioned as barriers for target group-based HIV testing. GPs assessed the current list of 64 indicator conditions as too difficult to integrate in routine care, deeming a reduced list of GP-relevant conditions as more feasible. Combined strategies (i.e. target group- and indicator-based testing) supported by official screening recommendations were perceived as successful strategies for provider-initiated HIV-testing in primary care. This formative research delivered qualitative evidence for the development of an HIV-testing intervention for primary care settings.
AB - General practitioners (GPs) play a key role in reducing the hidden HIV-epidemic, but many diagnostic opportunities are missed in primary care. This study aimed at informing the development of an HIV-testing intervention for GPs in Flanders (Belgium) using formative research with a participatory approach. Through the active involvement of an advisory board and 16 group discussions with 122 Flemish GPs, GPs' current HIV-testing practices and perceived practical relevance of 2 distinct HIV-testing strategies (i.e. provider-initiated testing of key populations and indicator condition-based testing) were explored in terms of their relevance and feasibility in routine primary care. Self-reported HIV-testing practices revealed that most tests performed were patient-initiated, pretest counseling was rarely done, and post-test counseling was offered mainly for patients with an HIV-diagnosis. GPs reported multiple barriers to provider-initiated HIV-testing, i.e. personal discomfort, fear of offending their patient, limited knowledge of benefits of early HIV-diagnosis, misconceptions about HIV-risks, lack of guidelines and time. Difficulties to identify patient's sexual orientation or ethical concerns were mentioned as barriers for target group-based HIV testing. GPs assessed the current list of 64 indicator conditions as too difficult to integrate in routine care, deeming a reduced list of GP-relevant conditions as more feasible. Combined strategies (i.e. target group- and indicator-based testing) supported by official screening recommendations were perceived as successful strategies for provider-initiated HIV-testing in primary care. This formative research delivered qualitative evidence for the development of an HIV-testing intervention for primary care settings.
KW - general practitioners
KW - HIV-testing
KW - intervention
KW - primary care
KW - qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85085536304&partnerID=8YFLogxK
U2 - 10.1093/heapro/daz037
DO - 10.1093/heapro/daz037
M3 - Article
C2 - 31056680
AN - SCOPUS:85085536304
SN - 0957-4824
VL - 35
SP - 301
EP - 311
JO - Health Promotion International
JF - Health Promotion International
IS - 2
ER -