Developing an Accident and Emergency HIV Testing Program in Belize City: Recommendations from Key Stakeholders.

Area of Science:

• Public Health
• Infectious Disease Research
• Healthcare Management

Background:

• Accident and Emergency (A&E) departments are critical points for public health interventions.
• Establishing HIV testing programs in emergency settings requires understanding stakeholder perspectives.
• Belize City's Karl Heusner Memorial Hospital Authority (KHMHA) is a key healthcare facility.

Purpose of the Study:

• To gather stakeholder input for developing an A&E department HIV testing program in Belize City.
• To identify potential facilitators and barriers to implementing HIV testing in emergency care.
• To inform the design of a culturally sensitive and effective HIV testing strategy.

Main Methods:

• Qualitative content analysis of semistructured interviews.
• Inclusion of diverse stakeholder groups: A&E patients, physicians, nurses, and hospital administrators.
• Focus on themes related to patient selection, training, confidentiality, and barriers/facilitators.

Main Results:

• Patients favored universal HIV testing, while other stakeholders preferred targeted testing.
• Key facilitators included respectful relationships, privacy, resources, coordination, and education.
• Significant barriers identified were stigmatization, patient willingness, inadequate resources, privacy concerns, and testing biases.

Conclusions:

• Stakeholder consensus is crucial for successful HIV testing program implementation.
• Addressing barriers like stigma and resource limitations is essential.
• Tailored training and robust confidentiality measures are vital for A&E-based HIV testing.