Factors associated with offering HIV testing to people aged ≥ 50 years: A qualitative study

Area of Science:

• Geriatric Medicine
• Infectious Diseases
• Public Health

Background:

• Individuals aged 50 years and older experience disproportionately high rates of late Human Immunodeficiency Virus (HIV) diagnosis.
• Late HIV diagnosis in older adults is linked to adverse health outcomes and increased risk of onward transmission.
• Despite clear guidelines and patient willingness, clinicians under-offer HIV testing to older patients.

Purpose of the Study:

• To identify clinician-related factors influencing the decision to offer HIV testing to patients aged 50 years and above.
• To understand the barriers preventing healthcare providers from offering HIV tests to older individuals.
• To inform strategies for improving HIV testing uptake in the geriatric population.

Main Methods:

• Qualitative study involving interviews with twenty clinicians.
• Participants had experience caring for older patients diagnosed late with HIV.
• Thematic analysis was used to analyze interview data.

Main Results:

• Seven key clinician-related factors emerged: knowledge gaps, stigma, stereotyping, risk perception, communication challenges, consent processes, and practical issues.
• Some identified barriers are common to all age groups, while others are specific to older patients.
• Clinicians often lack current HIV knowledge and experience anxiety discussing HIV with older adults, sometimes perceiving them as asexual.

Conclusions:

• Addressing clinician-specific barriers is essential to increase HIV testing offers for individuals aged 50 and over.
• Interventions should focus on updating clinician knowledge, mitigating stigma, and challenging age-related stereotypes.
• Improving communication strategies and addressing practical concerns can enhance HIV testing rates in older populations.