African American Patient Experiences With a Rapid HIV Testing Program in an Urban Public Clinic
African American Patient Experiences With a Rapid HIV Testing Program in an Urban Public Clinic
复制标题
DOI：
10.1016/s0027-9684(15)30125-5
复制
发表时间：
2012-01-01
影响因子：
3.3
通讯作者：
Kwakwa, Helena
中科院分区：
文献类型：
--
作者：
Nunn, Amy;Eng, Whitney;Kwakwa, Helena
背景：2008 年宾夕法尼亚州费城诊断出的 1174 例新的人类免疫缺陷病毒 (HIV) 病例中，共有 771 例 (66%) 为非裔美国人。费城最近在公共诊所推出了一项全市范围内的艾滋病毒快速检测计划。方法：我们对 60 名非裔美国人进行了一项定性研究，他们在费城一家公共诊所（位于艾滋病毒发病率高的邮政编码区）接受快速艾滋病毒检测。我们采用扎根理论，采用半结构化访谈来评估患者的动机、看法和快速 HIV 检测的临床经验。采访内容已被转录和编码； 20% 进行双重编码以提高可靠性。结果：进行快速 HIV 检测的主要动机包括：在常规临床护理期间进行检测、因有症状的性传播感染或机会性感染而寻求护理、了解 HIV/艾滋病感染者以及意识到自己有感染 HIV 的风险。大多数患者报告了快速检测的积极体验，并且比传统检测更喜欢快速检测，因为它消除了回访的需要并减少了焦虑；然而，许多人对快速艾滋病毒检测的准确性表示担忧。该人群中艾滋病毒检测的障碍包括自我感知风险低、艾滋病毒耻辱以及受访者社区中报道的恐同症。结论：这种快速检测计划是可以接受的、方便的，并且比传统的艾滋病毒检测更受欢迎。提供有关快速和确证性艾滋病毒检测的教育信息可能会进一步提高该人群对快速艾滋病毒检测的接受程度。在全国范围内扩大公共卫生中心的艾滋病毒快速检测是实现奥巴马总统国家艾滋病战略目标的重要且可接受的手段，该战略旨在减少艾滋病毒感染的种族差异并改善与艾滋病毒/艾滋病治疗和护理服务的联系。
Background: Of 1174 new human immunodeficiency virus (HIV) cases diagnosed in Philadelphia, Pennsylvania, in 2008, a total of 771 (66%) were among African Americans. Philadelphia recently introduced a citywide rapid HIV testing program in public clinics.Methods: We conducted a qualitative study among 60 African Americans undergoing rapid HIV testing in one of Philadelphia's public clinics located in a zip code with high HIV incidence. Employing grounded theory, we used semistructured interviews to assess patients' motivations, perceptions, and clinical experiences with rapid HIV testing. Interviews were transcribed and coded; 20% were double coded to enhance reliability.Results: Primary motivations for undergoing rapid HIV testing included: testing during routine clinical care, presenting for care with symptomatic sexually transmitted infections or opportunistic infections, knowing someone living with HIV/AIDS, and perceiving oneself at risk for HIV. Most patients reported positive experiences with rapid testing and preferred it to conventional testing because it eliminated the need for return visits and decreased anxiety; however, many expressed concerns about accuracy of rapid HIV testing. Barriers to HIV testing among this population included low self-perceived risk, HIV stigma, and reported homophobia in respondents' communities.Conclusion: This rapid testing program was acceptable, convenient, and preferred over conventional HIV testing. Providing educational information about rapid and confirmatory HIV testing may further enhance acceptability of rapid HIV testing in this population. Nationwide expansion of rapid HIV testing in public health centers is an important and acceptable means of achieving President Obama's National AIDS Strategy goals of reducing racial disparities in HIV infection and improving linkage to HIV/AIDS treatment and care services.