Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;23(4):1062-1072.
doi: 10.1007/s10461-018-02385-5.

Barriers to HIV Testing: Patient and Provider Perspectives in the Deep South

Jenni M Wise  1 , Corilyn Ott  1   2 , Andres Azuero  1 , Robin Gaines Lanzi  3 , Susan Davies  3 , Andrea Gardner  4 , David E Vance  1 , Mirjam-Colette Kempf  5   6   7   8
Affiliations

Barriers to HIV Testing: Patient and Provider Perspectives in the Deep South

Jenni M Wise et al. AIDS Behav. 2019 Apr.

Abstract

Although CDC guidelines call for universal, "opt-out" HIV testing, barriers to testing continue to exist throughout the United States, with the rural South particularly vulnerable to both HIV infection and decreased awareness of status. Therefore, the objectives of this study were to evaluate uptake of "opt-out" HIV testing and barriers to testing within the primary care setting in the South. A concurrent triangulation design guided the collection of quantitative data from patients (N = 250) and qualitative data from providers (N = 10) across three primary health clinics in Alabama. We found that 30% of patients had never been tested for HIV, with the highest ranked barrier among patients being perceived costs, access to specialty care, and not feeling at risk. Significant differences existed in perceived barriers between patients and providers. Increased provider-patient engagement and the routine implementation of "opt-out" HIV testing would effectively reveal and mitigate barriers to testing, thus, increasing awareness of status.

Keywords: Barriers; Delivery of health care; HIV; Health knowledge, attitudes, practice; Screening.

PubMed Disclaimer

Conflict of interest statement

All authors included on this manuscript declare that he/she has no conflict of interest.

Figures

Figure 1
Figure 1
Patient Rated Significance of Barriers to HIV Testing *Patients were asked to rate the importance of each barrier to HIV testing, with higher scores indicating a more hindering barrier.
Figure 2
Figure 2
Perceived Barriers to HIV Testing as Ranked by Providers *Providers were asked to rank patient barriers to HIV testing on a scale from one to eight, with lower scores indicating the most hindering barrier.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. HIV in the United States: At a glance. 2017. Retrieved from https://www.cdc.gov/hiv/statistics/overview/ataglance.html
    1. Farnham PG, Gopalappa C, Sansom SL, Hutchison AB, Brooks JT, Weidle PJ,…& Rimland D Updates of lifetime costs of care and quality-of-life estimates for HIV-infected persons in the United States: late versus early diagnosis and entry into care. J Acquir Immune Defic Syndr,.2013; 64(2): 183–9. doi: 10.1097/QAI.0b013e3182973966 - DOI - PubMed
    1. Hall HI, Holtgrave DR, Tang T, and Rhodes P HIV transmission in the United States: Considerations of viral load, risk behavior, and health disparities. AIDS Behav. 2013; 17(5): 1632–6. doi:10.1007/s10461-013-0426-z - DOI - PubMed
    1. Southern HIV/AIDS Strategy Initiative. February 2016: SASI releases: HIV/AIDS in the US Deep South: Trends from 2008–2013. 2016. Retrieved from https://southernaidsstrategy.org/research/
    1. White BL, Walsh J, Rayasam S, Pathman DE, Adimora AA, & Golin CE. What makes me screen for HIV? Perceived barriers and facilitators to conducting recommended routine HIV testing among primary care physicians in the southeastern United States. J Int Assoc Provid AIDS Care. 2015; 14(2): 127–135. doi: 10.1177/2325957414524025 - DOI - PMC - PubMed

MeSH terms