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Abstract
Improving HIV screening with nurse-initiated rapid testing and streamlined counseling
Anaya H.1, Asch S.2, Hoang T.2, Goetz M.3, Bowman C.4, Gifford A.5
Objectives: The CDC now recommends HIV testing to all seeking care, yet testing rates remain low, even among those at-risk and who have regular primary care. Implementing HIV testing into primary care poses organizational challenges. The primary aims of this project were to: 1) determine whether nurse-initiated referral for traditional HIV counseling and testing improved screening rates compared to current testing procedures; 2) determine whether nurse-initiated HIV rapid testing (RT) with streamlined counseling (SC) improves screening rates more than nurse-initiated referral for traditional counseling and testing alone. Secondary aims evaluated knowledge retention regarding current HIV counseling procedures versus a modified, streamlined counseling approach.
Methods: The study was conducted in two VA clinics in the same city: One large urban hospital, one freestanding outpatient clinic in an area of high HIV prevalence. 251 patients with scheduled or walk-in appointments for primary/urgent care were recruited. The study was designed as a randomized, controlled trial with three intervention models: Model A-traditional counseling/testing; Model B-nurse-initiated screening, traditional counseling/ testing; Model C-nurse-initiated screening with streamlined counseling/rapid testing. Measurement included rates of HIV testing and receipt of results; reduction in sexual risk and HIV knowledge improvement.
Results: Testing rates were 40.2% (Model A), 84.5% (Model B), and 89.3% (Model C) (p=<.01). Rates of receipt of test results were 14.6% (Model A), 31.0% (Model B), 79.8% (Model C) (p=<.01). Reduction in sexual risk and HIV knowledge improvement did not differ significantly between traditional versus streamlined counseling.
Conclusions: Streamlined counseling with rapid testing significantly increased rates of testing and receipt of results over current practice without any change in post-test knowledge or risk behavior. Increased rates of testing and receipt of results could lead to earlier disease identification, increased treatment and reduced morbidity/mortality. Managers and policymakers should consider streamlined counseling with routine rapid testing when implementing HIV testing into primary/urgent care.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
TUPDB07
Suggested Citation
"AnayaH., et al.
Improving HIV screening with nurse-initiated rapid testing and streamlined counseling.
Poster discussion:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
TUPDB07"
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