Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.

<h4>Introduction</h4>Emergency Department (ED)-based HIV counseling and testing (HCT) has had a significant impact on improving rates of HIV diagnosis and linkage to care. Unfortunately, expansion of this strategy to low- and middle-income countries has been limited. Successful implement...

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Autores principales:	Aditi Rao, Emily M Nagourney, Victoria H Chen, Sarah Hill, Eili Y Klein, Madeleine Whalen, Thomas C Quinn, Bhakti Hansoti
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4d92686e57a345b699bf3c124ce612ae
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spelling	oai:doaj.org-article:4d92686e57a345b699bf3c124ce612ae2021-11-25T06:23:40ZAssessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.1932-620310.1371/journal.pone.0252372https://doaj.org/article/4d92686e57a345b699bf3c124ce612ae2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252372https://doaj.org/toc/1932-6203<h4>Introduction</h4>Emergency Department (ED)-based HIV counseling and testing (HCT) has had a significant impact on improving rates of HIV diagnosis and linkage to care. Unfortunately, expansion of this strategy to low- and middle-income countries has been limited. Successful implementation of ED-based HCT is dependent on patient and provider acceptance of the intervention, and their attitudes and pre-existing biases towards the disease. This study sought to develop validated survey instruments to assess attitudes towards ED-based HCT.<h4>Methods</h4>This cross-sectional study surveyed patients and providers in three EDs in the Eastern Cape province, South Africa. A convenience sample of patients and providers in the ED were surveyed. Exploratory factor analysis was conducted using questions on attitudes to HIV testing to develop validated survey instruments. An ANOVA test assessed variance in attitudes towards HCT based on demographic variables collected.<h4>Results</h4>A total of 104 patient and 132 provider surveys were completed. Exploratory factor analysis resulted in a 17- and 7-question attitudes survey for patients and providers, respectively. Overall, 92.3% of patients and 70.7% of providers supported ED-based HCT, however, both groups displayed only mildly positive attitudes. Questions representing 'confidentiality' and 'stigma around HIV testing' had the least positive influence on patients' overall attitudes. Questions representing 'comfort with HIV testing' had the least positive influence on providers' overall attitudes.<h4>Conclusion</h4>Our study demonstrated ED patients and providers are generally supportive of ED-based HCT. A validated survey instrument was able to provide a standardized approach to identify barriers to HCT implementation in an ED setting, across contexts. For successful implementation, behavioral interventions must focus on strengthening patient beliefs around confidentiality and the consent process, and providers' comfort levels with providing HIV testing services in the ED.Aditi RaoEmily M NagourneyVictoria H ChenSarah HillEili Y KleinMadeleine WhalenThomas C QuinnBhakti HansotiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0252372 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Aditi Rao Emily M Nagourney Victoria H Chen Sarah Hill Eili Y Klein Madeleine Whalen Thomas C Quinn Bhakti Hansoti Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
description	<h4>Introduction</h4>Emergency Department (ED)-based HIV counseling and testing (HCT) has had a significant impact on improving rates of HIV diagnosis and linkage to care. Unfortunately, expansion of this strategy to low- and middle-income countries has been limited. Successful implementation of ED-based HCT is dependent on patient and provider acceptance of the intervention, and their attitudes and pre-existing biases towards the disease. This study sought to develop validated survey instruments to assess attitudes towards ED-based HCT.<h4>Methods</h4>This cross-sectional study surveyed patients and providers in three EDs in the Eastern Cape province, South Africa. A convenience sample of patients and providers in the ED were surveyed. Exploratory factor analysis was conducted using questions on attitudes to HIV testing to develop validated survey instruments. An ANOVA test assessed variance in attitudes towards HCT based on demographic variables collected.<h4>Results</h4>A total of 104 patient and 132 provider surveys were completed. Exploratory factor analysis resulted in a 17- and 7-question attitudes survey for patients and providers, respectively. Overall, 92.3% of patients and 70.7% of providers supported ED-based HCT, however, both groups displayed only mildly positive attitudes. Questions representing 'confidentiality' and 'stigma around HIV testing' had the least positive influence on patients' overall attitudes. Questions representing 'comfort with HIV testing' had the least positive influence on providers' overall attitudes.<h4>Conclusion</h4>Our study demonstrated ED patients and providers are generally supportive of ED-based HCT. A validated survey instrument was able to provide a standardized approach to identify barriers to HCT implementation in an ED setting, across contexts. For successful implementation, behavioral interventions must focus on strengthening patient beliefs around confidentiality and the consent process, and providers' comfort levels with providing HIV testing services in the ED.
format	article
author	Aditi Rao Emily M Nagourney Victoria H Chen Sarah Hill Eili Y Klein Madeleine Whalen Thomas C Quinn Bhakti Hansoti
author_facet	Aditi Rao Emily M Nagourney Victoria H Chen Sarah Hill Eili Y Klein Madeleine Whalen Thomas C Quinn Bhakti Hansoti
author_sort	Aditi Rao
title	Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
title_short	Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
title_full	Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
title_fullStr	Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
title_full_unstemmed	Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.
title_sort	assessing attitudes to ed-based hiv testing: development of a short-structured survey instrument.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4d92686e57a345b699bf3c124ce612ae
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Assessing attitudes to ED-based HIV testing: Development of a short-structured survey instrument.

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