3. Promoting HIV Testing in Diverse Populations
Discovering Barriers to Wider Use of HIV Screening
Two fundamental goals of routine HIV testing efforts are to identify a larger percentage of HIV-infected patients and to increase the number of those who are identified who are linked into care—that is visiting a healthcare provider within 3 to 6 months after learning an HIV diagnosis. [CDC Meeting summary] The following are common challenges to efforts to identify and care for more HIV-positive patients:
- Lack of diversity among healthcare leadership and staffs
- Systems of care that are poorly designed for diverse populations
- Inadequate cross-cultural communication between providers and patients
- Patient fears and distrust
- Cultural stigma
Particular population groups continue to experience disproportionate rates of HIV infection. [Natl Center on HIV/AIDS 2010] Reducing disparities in HIV infection rates and increasing the numbers of individuals receiving appropriate care will require practitioners to apply thorough, culturally competent approaches. [CDC Epidemiology 2006]
Members of certain racial and ethnic populations, some women, and men who have sex with men (MSM) have unique needs that healthcare providers should make comprehensive efforts to understand and address. [Alexander clinical guide] To assist these groups’ engagement in the healthcare system, practitioners can employ the following approaches:
- Establish a personal connection with the patient during the initial visit
- Arrange for the patient to meet with a case manager, social worker, or outreach worker during the initial visit
- Obtain contact information for at least 2 close personal contacts to facilitate follow-up if the patient fails to return [Alexander clinical guide]
