Why don't physicians test for HIV? A review of the US literature.

摘要: Objective In its 2006 HIV testing guidelines, the Centers for Disease Control and Prevention (CDC) recommended routine in all US medical settings. Given that many physicians do not routinely test HIV, objective of this study was to summarize our current understanding why offer testing. Design A comprehensive review published unpublished literature on barriers conducted. Methods search conducted Pubmed using defined terms. Other sources included Google, recent conference abstracts, experts field. Studies were divided into three categories: prenatal; emergency department; other These categories chosen because differences physician training, practice environment, patient populations. Barriers identified these summarized separately settings compared. Results Forty-one from 17 reports. Twenty-four named prenatal setting, 20 department 23 Eight insufficient time; burdensome consent process; lack knowledge/training; acceptance; pretest counselling requirements; competing priorities; inadequate reimbursement. Conclusion experience policy-based, logistical, educational Although some are exclusive setting studied, substantial overlap found across Some or must be addressed before CDC recommendation can realized