A comprehensive theoretical framework for the implementation and evaluation of opt-out HIV testing

Area of Science:

• Public Health
• Health Services Research
• Behavioral Science

Background:

• Opt-out HIV testing is a strategy to increase HIV status awareness and reduce transmission.
• Implementing opt-out HIV testing requires a theoretical foundation for effective change management.

Purpose of the Study:

• To explore the application of three theories to guide the implementation and evaluation of opt-out HIV testing programs.
• To enhance healthcare provider motivation and inform operational aspects of opt-out HIV testing.

Main Methods:

• Consideration of Behavioural Economics, the Health Belief Model, and Normalisation Process Theory.
• Application of these theories to motivate healthcare providers and inform program operations.

Main Results:

• Theoretical integration can motivate healthcare providers to order more HIV tests.
• Theories can influence provider beliefs about testing eligibility and operationalize opt-out programs.

Conclusions:

• Theoretical support is crucial for successful opt-out HIV testing implementation.
• Process evaluation guided by these theories can improve provider self-efficacy, collective action, testing rates, and health outcomes.