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Chuen-Yen Lau, MD, MS, School of Public Health, University of California at Los Angeles, 6700B Rockledge Dr, Room 5249, Bethesda, MD 20817, (240) 460-1034, chuenyenlau@hotmail.com, Adamson Muula, MB, BS, Department of Community Health, University of Malawi College of Medicine, Private Bag 360, Blantyre, Malawi, Tilera Dzingomvera, MB, BS, Blantyre Adventist Hospital, PO Box 51, Blantyre, Malawi, and Gregory Horwitz, PhD, Vision Center Laboratory, Salk Institute for Biological Sciences, 10010 North Torrey Pines Road, La Jolla, CA 92037.
Context: HIV testing may be cost-effective in reducing HIV-related morbidity and mortality. Since Malawi is impacted by HIV/AIDS and detection of cases is sub-optimal, reasons clinicians might not offer HIV testing should be identified. Objective: Identify reasons clinicians in Malawi might not offer HIV testing. Design, Setting and Participants: Cross-sectional, descriptive, postal survey techniques with telephone and fax follow-up were used to collect a census of clinicians in Malawi. Demographic information and reasons for not offering HIV tests were solicited. Main Outcome Measures: Proportions were calculated for each reason. Logistic regression was used to determine whether responses differed by demographics. Results: 523 of 982 (53.26%) clinicians responded. Mean age was 43.56+/-12.93. The five most common reasons for not offering tests were: inadequate training in HIV counseling (50.29%); patient unready (49.52%); no indication (35.56%); facilities unavailable (35.37%); and insufficient time (28.87%). Of six professional categories, medical assistants were most likely to give the reason inadequate training in HIV counseling (OR 95% CI (2.27, 5.57)) and less likely to give the reason patient not ready (0.382, 0.893). General practitioners were more likely to give the reason patient not ready (1.087, 3.65) and less likely to give the reason testing facility unavailable (0.214, 0.800). Conclusions: Differences in reasons for not offering HIV tests amongst clinician groups were few. Thus development of one general program based on common reasons identified in this study could be effective in increasing HIV testing rates. Further investigation of the identified reasons should be undertaken to facilitate program development.
Learning Objectives:
Keywords: HIV/AIDS,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.