In 2006, the Centers for Disease Control (CDC) recommended HIV screening for all individuals 13-64 years of age, annual testing for persons at higher risk and changes in HIV testing laws. 10 years after these recommendations are made; many providers are unaware of them and screening remains low. This study aims to evaluate Internal Medicine (IM) residents’ knowledge and assess the rate of HIV screening at multiple community health centers (CHC).
A cross sectional survey of IM residents at 1 University and 3 Community Hospitals, in Chicago was conducted from November to December 2015 that included questions about knowledge, practice and barriers to HIV testing. Association between gender, age, year of graduation, post-graduate year, training site of the resident and knowledge and practice of HIV screening was assessed by Chi-square tests and logistic regression. Adherence to guidelines was assessed separately through medical record search of 35 federally qualified CHC across Chicago area.
Of the 192 residents surveyed, 67.7% responded. 61% were male, 19% graduated from medical school >7 years ago. Although, 82% reported receiving lectures about HIV, only 56% knew about universal screening, 33% were unaware of need for repeated screening in persons at higher risk and 34% didn't know that men who have sex with men is the most common mode of HIV transmission. 62% were not aware of Illinois HIV testing laws. 64% ordered ≤10 HIV tests over a 6 month period, 48 % occasionally or hardly ever asked about sexual history. Most common reported barriers were: urgent care issues (31%); lack of time (29%) and patient being uncomfortable discussing HIV (23%). Only the training site showed statistically significant association with knowledge about HIV screening (p<0.05). HIV testing data collected from 35 CHC showed HIV screening rate of < 20%.
This study identified the gaps in knowledge and barriers to HIV screening among IM residents. It also showed low screening rate in multiple CHC across Chicago. Lack of awareness regarding the new recommendations might be contributing to infrequent HIV testing. More efforts and innovative methods are needed to better integrate the new recommendations in the curriculum of residents and help achieve the goal of universal HIV screening.
R. Habibi, None
A. Altamirano, None
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