Clinician Barriers and Facilitators to Routine HIV Testing: A Systematic Review of the Literature

Routine HIV screening rates are suboptimal.

This systematic review identified barriers to/facilitators of routine HIV testing, categorized them using the socioecological model (SEM), and provided recommendations for interventions to increase screening.

Included articles were indexed in PubMed, EBSCO CINAHL, Scopus, Web of Science, and the Cochrane Library between 2006 and October 2018.

Included studies were published in English or Spanish and directly assessed providers' barriers/facilitators to routine screening.

We used a standardized Excel template to extract barriers/facilitators and identify levels in the SEM.

Intrapersonal factors predominated as barriers, while facilitators were directed at the institutional level.

Policy barriers are not universal across countries. Meta-analysis was not possible. We could not quantify frequency of any given barrier/facilitator.

Increasing reimbursement and adding screening as a quality measure may incentivize HIV testing; however, many interventions would require little resource investment.