Universal-offer HIV testing in primary care: A mixed-methods evaluation of a pilot study

Area of Science:

• Public Health
• Primary Care Medicine
• Infectious Disease Prevention

Background:

• National Institute for Health and Care Excellence (NICE) guidelines recommend universal HIV testing in primary care since 2016.
• Adoption of routine HIV testing in UK primary care settings remains suboptimal.
• This study evaluated the acceptability and feasibility of integrating HIV testing into routine blood test appointments.

Purpose of the Study:

• To assess patient and healthcare professional (HCP) acceptance of routine HIV testing during blood draws.
• To determine the feasibility of implementing a universal HIV testing service in primary care.
• To identify barriers and facilitators to HIV test uptake in this setting.

Main Methods:

• A 3-week pilot study was conducted in a UK general practice.
• A mixed-methods approach included quantitative data on test offers and acceptance, and qualitative semi-structured interviews.
• Patient demographics (age, gender) were analyzed for associations with test offer and acceptance.

Main Results:

• Of 251 patients attending for blood tests, 46.6% were offered an HIV test, with 78.6% accepting. No demographic differences in offer or acceptance were found.
• Patient interviews indicated the offer was perceived as routine and non-judgmental; SMS for negative results was acceptable.
• Healthcare professionals reported no significant service-level barriers, but the proportion of patients offered testing varied by the individual HCP.

Conclusions:

• Routine HIV testing during blood tests in primary care is a feasible and acceptable strategy.
• The primary barrier to increased HIV testing uptake is the inconsistent offering of tests by healthcare professionals.
• Optimizing HIV testing requires addressing HCPs' practices in offering tests to eligible patients.