Determinants of HIV testing

To determine the characteristics of general practitioners (GPs) who test and patients who are tested for HIV in Australia.

A secondary analysis of data from the Bettering the Evaluation and Care of Health programme; a cross-sectional, national survey of GP activity.

We identified GP, patient and encounter characteristics that were associated with HIV testing between April 2000 and March 2010. We looked at testing rates for patients with different characteristics, whether they had attended for screening and GP 'risk factor' identification. Multiple logistic regression was used to measure the independent effect of each GP, patient and encounter characteristic on testing for HIV.

Data were available for 984,200 encounters from 9842 GPs. 1796 (18.2%) of GPs performed at least one HIV test. On logistic regression, independent predictors of HIV testing included the management of a 'risk factor' (OR 19.4, 95% CI 17.4 to 21.6), screening (OR 10.6, 95% CI 9.4 to 12.1), younger GP age, practice in a metropolitan area (OR 1.4, 95% CI 1.2 to 1.6), patient age, gender (male > female OR 3.0, 95% CI 2.7 to 3.3), being new to that practice (OR 2.1, 95% CI 1.8 to 2.3) and being Indigenous (OR 1.7, 95% CI 1.3 to 2.4).

The most significant independent predictors of testing were identification of a risk factor and attendance for screening. Unless barriers to testing are addressed it is unlikely that altering guidelines alone will improve testing rates and reduce transmission.