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).