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Opportunities for improved indicator-based HIV testing in the hospital setting: a structural equation model analysis
Saskia Bogers1,2,3, Anders Boyd2,4,5, Maarten Schim van der Loeff1,2,4
1Internal Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
AIDS Care
|September 8, 2023
Summary
Indicator condition (IC)-guided HIV testing is effective for identifying undiagnosed individuals. Interventions should focus on guideline implementation, physician attitude, and self-efficacy for improved HIV testing behavior.
Area of Science:
- Public Health
- Epidemiology
- Health Behavior
Background:
- Indicator condition (IC)-guided HIV testing is a feasible and cost-effective strategy to identify individuals with undiagnosed HIV.
- Assessing the determinants of IC-guided testing can reveal areas for improvement in HIV screening practices.
Purpose of the Study:
- To assess the determinants of IC-guided HIV testing behavior among hospital physicians.
- To evaluate the influence of Theory of Planned Behaviour (TPB) domains on HIV testing intention and behavior.
Main Methods:
- A survey study was conducted among 163 hospital physicians in Amsterdam, utilizing the TPB framework.
- Structural equation modeling analyzed the association between TPB domains (attitude, belief, norms, self-efficacy, behavioral control) and HIV testing intention/behavior.
- The impact of guideline recommendations on testing behavior was also considered.
Main Results:
- Physicians' actual HIV testing behavior (mean score 2.8) was significantly lower than their intention to test (mean score 3.8).
- The direct model linking TPB determinants to behavior showed a better fit than the intention-mediated model.
- Physicians' attitude towards IC-guided testing and self-efficacy were key correlates of actual testing behavior.
Conclusions:
- Interventions to enhance IC-guided HIV testing in hospitals should prioritize implementing guideline recommendations.
- Improving physicians' attitudes and self-efficacy regarding IC-guided HIV testing are crucial for increasing actual testing behavior.
- Addressing discrepancies between testing intention and behavior is essential for effective HIV screening strategies.
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