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M9480104.TXT
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1994-08-09
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Document 0104
DOCN M9480104
TI HIV antibody testing: the gap between policy and practice.
DT 9410
AU Pomeroy C; Sandry J; Moldow DG; Department of Veterans Affairs Medical
Center, Minneapolis, MN; 55417.
SO J Acquir Immune Defic Syndr. 1994 Aug;7(8):816-22. Unique Identifier :
AIDSLINE MED/94293163
AB In response to recent laws regulating human immunodeficiency virus (HIV)
antibody testing practices in all federal hospitals, our
university-affiliated Veterans Affairs Hospital instituted several
interventions designed to increase appropriate testing. Specific
hospital policy requiring restriction of testing to high-risk
individuals, provision of pre- and posttest counseling, and
documentation of written consent was instituted. In addition, an
education campaign to inform physicians of hospital policy and training
of counselors as physician extenders was undertaken. To determine the
efficacy of these interventions, we reviewed all HIV antibody tests
performed during a subsequent six-month period (n = 221). Only 14% of
tests met all hospital policy requirements. The decision to test was
prompted by identification of a risk factor or other acceptable reason
for testing for only 31% of patients. Risk reduction counseling was
provided for only 28% of patients. Written consent was documented for
62% of patients. Health care providers on surgical services were less
likely than others to comply with hospital policy (p < 0.0001). We
conclude that an interventional program including specific hospital
policy mandates, physician education, and provision of trained
counselors was not adequate to ensure optimal HIV antibody testing
practices. If this gap between policy and practice is to be closed,
additional interventions, or alternatively modification of policy
guidelines, will be needed.
DE Adult Age Factors AIDS Serodiagnosis/LEGISLATION &
JURISPRUD/*STANDARDS/ *UTILIZATION Counseling Female Health
Policy/*LEGISLATION & JURISPRUD Hospitals, Veterans/*LEGISLATION &
JURISPRUD/STANDARDS Human HIV Antibodies/*ANALYSIS HIV
Infections/DIAGNOSIS/EPIDEMIOLOGY Informed Consent Male Middle Age
Minnesota Organizational Policy Physician's Practice
Patterns/*STATISTICS & NUMER DATA/STANDARDS Preoperative Care Risk
Factors Sex Behavior Support, U.S. Gov't, Non-P.H.S. United States
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).