How to Overcome the 5 Barriers to Production App Security Testing
Barriers to HIV testing outside the HIV-specialist setting and how to overcome them
-
Upload
paula-carr -
Category
Documents
-
view
20 -
download
0
description
Transcript of Barriers to HIV testing outside the HIV-specialist setting and how to overcome them
![Page 1: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/1.jpg)
1
Barriers to HIV testing outside the HIV-specialist setting
and how to overcome them
![Page 2: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/2.jpg)
2
HIV testing – pre-HAART
Benefits of testingLimited treatmentPrognosis poorHighly stigmatisedBarriers to
testingClinicians:•Feeling deskilled•Time pressures•Specialists only•Patients:•Feeling affronted by presumed assumptions
•Who to tell, who not to tell•Implications of positive result
![Page 3: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/3.jpg)
3
HIV testing – post-HAART
Benefits of testing Effective treatment(Cost-effective!)Good prognosisLegal protections
Barriers to testingClinicians:•Skills used in daily practice•Routine investigation•Any healthcare professionalPatients:•Routine investigation•Clear information•Benefits explained
![Page 4: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/4.jpg)
4
What worked in other settings?
• Setting a national target for HIV testing– Antenatal: 90% uptake by 2002– GUM: 60% uptake by 2007
• Including HIV test in routine screen– Opt-out strategy
• Discarding routine in-depth pre-test ‘counselling’– Using patient information leaflets on HIV test– Emphasising benefits of knowing HIV status– NB: high-risk patients may need more in-depth work
![Page 5: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/5.jpg)
5
Uptake and outcome of HIV testing in sentinel GUM clinics, UK
![Page 6: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/6.jpg)
Estimated proportion of HIV-infected pregnant women diagnosed before delivery1 and of exposed infants becoming infected with HIV2, England & Scotland
6
![Page 7: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/7.jpg)
7
Key partnerships
• Public Health• Microbiologists• Clinicians• PCT commissioners• Care Pathways
– Primary and secondary care providers– Voluntary organisations– Network development (sub-regional)
![Page 8: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/8.jpg)
8
“What was the WR result?”
Syphilis – the great mimic
The venereologist’s contribution
The Grand Round
![Page 9: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/9.jpg)
9
The Grand Round
“What was the HIV test result?”
HIV – the 21st century mimic
The GUM physician’s contribution
![Page 10: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/10.jpg)
10
What needs to be in place?
• Education– Grand rounds – think HIV!– Specialty rounds– Postgraduate seminars
• Support– Prepare local guidelines and protocols– Clarify referral and care pathways– Develop patient information
• Monitoring– Joint research / audit projects– PCT targets and audits– Auditable standards in HIV testing guidelines
![Page 11: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/11.jpg)
11
Summary
• Benefits of HIV detection far outweigh risks• Opt-out testing overcomes barriers
So…• Develop partnerships• Support colleagues and patients• Challenge stigma• Monitor outcomes• Learn from experience elsewhere
![Page 12: Barriers to HIV testing outside the HIV-specialist setting and how to overcome them](https://reader035.fdocuments.in/reader035/viewer/2022070400/56813524550346895d9c8c13/html5/thumbnails/12.jpg)
12
Also contains
UK National Guidelines for HIV Testing 2008
from BASHH/BHIVA/BIS
Available from:
[email protected] or 020 7383 6345