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HIV testing in primary care: feasibility and acceptability of provider initiated HIV testing and counseling for sub-Saharan African migrants.

Authors
  • Loos, Jasna
  • Manirankunda, Lazare
  • Hendrickx, Kristin
  • Remmen, Roy
  • Nöstlinger, Christiana
Type
Published Article
Journal
AIDS education and prevention : official publication of the International Society for AIDS Education
Publication Date
Feb 01, 2014
Volume
26
Issue
1
Pages
81–93
Identifiers
DOI: 10.1521/aeap.2014.26.1.81
PMID: 24450280
Source
Medline
License
Unknown

Abstract

Provider-initiated HIV testing and counseling (PITC) is recommended to reduce late HIV diagnoses, common among Sub-Saharan African migrants (SAM) residing in Europe. Primary care represents an ideal entry point for PITC. To support Flemish general practitioners (GPs), we developed a culturally sensitive PITC tool. Over a 12-week period, 65 GPs implemented PITC to assess acceptability and feasibility of PITC. The qualitative evaluation showed high acceptability among physicians. Routine PITC was challenged by physicians' personal discomfort, assumptions of patients' sexual risk, perceived incoherence with reasons for consultation, and time pressure. The best opportunity for PITC was an indicated blood analysis for other medical reasons. Counseling skills improved during the implementation, but participants still advocated for reduced counseling requirements. PITC proved to be feasible in primary care settings, but the up-scaling requires a reformulation of counseling guidelines, a policy stipulating the role of GPs in the prevention-care continuum, and an investment in (continuous) training.

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