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Determinants of HIV testing
  1. Shailendra Sawleshwarkar1,
  2. Christopher Harrison2,
  3. Helena Britt2,
  4. Adrian Mindel1
  1. 1Sexually Transmitted Infections Research Centre and University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Family Medicine Research Centre, Sydney School of Public Health, University of Sydney, New South Wales, Australia
  1. Correspondence to Dr Adrian Mindel, Sexually Transmitted Infections Research Centre and University of Sydney, Marian Villa, Westmead Hospital, Westmead, NSW 2145, Australia; adrian.mindel{at}sydney.edu.au

Abstract

Objective To determine the characteristics of general practitioners (GPs) who test and patients who are tested for HIV in Australia.

Design and Setting A secondary analysis of data from the Bettering the Evaluation and Care of Health programme; a cross-sectional, national survey of GP activity.

Methods We identified GP, patient and encounter characteristics that were associated with HIV testing between April 2000 and March 2010. We looked at testing rates for patients with different characteristics, whether they had attended for screening and GP ‘risk factor’ identification. Multiple logistic regression was used to measure the independent effect of each GP, patient and encounter characteristic on testing for HIV.

Results Data were available for 984 200 encounters from 9842 GPs. 1796 (18.2%) of GPs performed at least one HIV test. On logistic regression, independent predictors of HIV testing included the management of a ‘risk factor’ (OR 19.4, 95% CI 17.4 to 21.6), screening (OR 10.6, 95% CI 9.4 to 12.1), younger GP age, practice in a metropolitan area (OR 1.4, 95% CI 1.2 to 1.6), patient age, gender (male > female OR 3.0, 95% CI 2.7 to 3.3), being new to that practice (OR 2.1, 95% CI 1.8 to 2.3) and being Indigenous (OR 1.7, 95% CI 1.3 to 2.4).

Conclusion The most significant independent predictors of testing were identification of a risk factor and attendance for screening. Unless barriers to testing are addressed it is unlikely that altering guidelines alone will improve testing rates and reduce transmission.

  • HIV testing
  • general practice
  • primary care
  • HIV screening
  • barriers to HIV screening
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Footnotes

  • Funding During the data collection period of this substudy, the BEACH programme was funded by the Australian Government Department of Health and Ageing, the Australian Institute of Health and Welfare, National Prescribing Service Ltd, Abbott Australia, AstraZeneca Pty Ltd (Australia), Janssen-Cilag Pty Ltd, Merck, Sharp and Dohme (Australia) Pty Ltd, Pfizer Australia, Sanofi Aventis Australia Pty Ltd, Wyeth Australia Pty ltd, Roche Products, Aventis Pharma Pty Ltd, the Office of the Australian Safety and Compensation Council (Australian Government Department of Employment and Workplace Training) and the Australian Government Department of Veterans’ Affairs.

  • Competing interests None declared.

  • Ethics approval BEACH data collection for this study was approved by the Human Research Ethics Committee of the University of Sydney and the Ethics Committee of the Australian Institute of Health and Welfare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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