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Refusing HIV testing in an urgent care setting: results from the "Think HIV" program.
Rebecca V Liddicoat1, Elena Losina, Minhee Kang
1Department of Medicine, Greater Los Angeles Veterans Affairs, Los Angeles, California 90073, USA. rebecca.liddicoat@med.va.gov
AIDS Patient Care and Stds
|February 16, 2006
Summary
High rates of human immunodeficiency virus (HIV) test refusal in urgent care settings hinder case identification. Identifying patient characteristics associated with refusal is crucial for improving HIV testing program uptake.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Services Research
Background:
- Routine voluntary human immunodeficiency virus (HIV) testing aims to increase case identification but faces significant patient refusal.
- Understanding factors influencing refusal is essential for enhancing the effectiveness of HIV screening programs.
Purpose of the Study:
- To identify patient characteristics associated with refusal of routine HIV testing in an urgent care setting.
- To inform strategies for improving HIV test acceptance rates.
Main Methods:
- A prospective HIV testing program was implemented across four Massachusetts urgent care centers.
- Patient demographics and reasons for refusal were analyzed using crude and multivariate statistical models.
Main Results:
- A substantial 67% of 9129 patients offered HIV testing refused.
- Crude analysis linked refusal to female gender, white race, older age, and higher education.
- Multivariate analysis identified non-English speaking, Hispanic, Haitian, and other race as more likely to refuse.
Conclusions:
- Two-thirds of patients refused routine HIV testing in this urgent care program.
- Targeted strategies are needed to increase HIV test acceptance among specific patient populations.
- Addressing perceived risk and prior testing status may improve uptake.