1. HIV testing in primary care: feasibility and acceptability of provider initiated HIV testing and counseling for sub-Saharan African migrants.
- Author
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Loos J, Manirankunda L, Hendrickx K, Remmen R, and Nöstlinger C
- Subjects
- AIDS Serodiagnosis, Adult, Africa South of the Sahara ethnology, Attitude of Health Personnel, Belgium epidemiology, Cultural Competency, Emigrants and Immigrants psychology, Feasibility Studies, Female, General Practitioners, HIV Infections ethnology, HIV Infections psychology, Humans, Male, Mass Screening psychology, Middle Aged, Patient Acceptance of Health Care, Physician-Patient Relations, Practice Guidelines as Topic, Qualitative Research, Surveys and Questionnaires, Counseling, HIV Infections diagnosis, HIV Infections prevention & control, Mass Screening methods, Physician's Role, Primary Health Care methods
- Abstract
Provider-initiated HIV testing and counseling (PITC) is recommended to reduce late HIV diagnoses, common among Sub-Saharan African migrants (SAM) residing in Europe. Primary care represents an ideal entry point for PITC. To support Flemish general practitioners (GPs), we developed a culturally sensitive PITC tool. Over a 12-week period, 65 GPs implemented PITC to assess acceptability and feasibility of PITC. The qualitative evaluation showed high acceptability among physicians. Routine PITC was challenged by physicians' personal discomfort, assumptions of patients' sexual risk, perceived incoherence with reasons for consultation, and time pressure. The best opportunity for PITC was an indicated blood analysis for other medical reasons. Counseling skills improved during the implementation, but participants still advocated for reduced counseling requirements. PITC proved to be feasible in primary care settings, but the up-scaling requires a reformulation of counseling guidelines, a policy stipulating the role of GPs in the prevention-care continuum, and an investment in (continuous) training.
- Published
- 2014
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