Evidence map›Paper›PMID 38960973›Full record

ArticleCJEM2024

Barriers and facilitators to the implementation of rapid HIV testing in Canadian Emergency Departments: a mixed methods study.

Jessica T Kent, Lisa M Puchalski Ritchie, Michelle Klaiman, Evelyn Marion Dell, Meghan Garnett, Megan Landes, Galo Fernando Ginocchio, Aya Alsefaou

Erratum issuedAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in CJEM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Jessica T KentDepartment of Medicine, University of Toronto, Toronto, ON, Canada. jekent@nosm.ca.ORCID 0000-0003-4017-7479
Lisa M Puchalski RitchieDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Michelle KlaimanDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Evelyn Marion DellDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Meghan GarnettEmergency and Critical Care Services, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada.
Megan LandesDepartment of Emergency Medicine, University Health Network, Toronto, ON, Canada.
Galo Fernando GinocchioEmergency Department, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Aya AlsefaouTemerty Medicine, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectives1 in 7 Canadians with Human Immunodeficiency Virus (HIV) do not know their status. Patients at increased risk of HIV routinely access the emergency department (ED), yet few are tested, representing a missed opportunity for diagnosis and linkage-to-care. Rapid HIV testing provides reliable results within the same ED encounter but is not routinely implemented. The objective of this study was to identify barriers and facilitators to rapid HIV testing in Ontario EDs.

methodsWe employed a mixed-methods, convergent, parallel design study including online surveys and semi-structured interviews of physicians, nurses, and allied health across four hospitals in Toronto and Thunder Bay, Ontario. Data were analyzed in equal priority using descriptive statistics for quantitative data and thematic analysis for qualitative data guided by the Theoretical Domains framework and Capability, Opportunity, Motivation Behaviour change model.

resultsAmong 187 survey respondents, 150 (80%) felt implementing rapid HIV testing would be helpful in the ED. Facilitators included availability of resources to link patients to care after testing (71%), testing early in patient encounters (41%), and having dedicated staff with lived experience support testing (34%). Motivation to offer testing included opportunities to support an underserved population (66%). Challenges to implementation included limited time during ED patient encounters (51%) and a lack of knowledge around HIV testing (42%) including stigma. Interview themes confirmed education, and integration of people with lived experience being essential to provide rapid HIV testing and linkage-to-care in the ED.

conclusionsImplementation of rapid HIV testing in the ED is perceived to be important irrespective of practice location or profession. Intrinsic motivations to support underserved populations and providing linkage-to-care are novel insights to facilitate testing in the ED. Streamlined implementation, including clear testing guidelines and improved access to follow-up care, is felt to be necessary for implementation.

Indexed as

Emergency Service, HospitalHIV InfectionsHIV TestingAdultCanadaFemaleHealth Services AccessibilityHumansMaleMass ScreeningMiddle AgedOntarioQualitative ResearchSurveys and QuestionnairesBarriers and facilitatorsHIV testingMixed methodsQualitative research

Identifiers

PMID38960973

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.