'A routine thing': clinician strategies for implementing HIV testing for at-risk patients in a busy healthcare organisation (and implications for implementation of other new practice recommendations)
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| Title: | 'A routine thing': clinician strategies for implementing HIV testing for at-risk patients in a busy healthcare organisation (and implications for implementation of other new practice recommendations) |
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| Authors: | Sobo EJ (AUTHOR), Bowman C (AUTHOR), Halloran J (AUTHOR), Asch SM (AUTHOR), Goetz MB (AUTHOR), Gifford AL (AUTHOR) |
| Source: | Anthropology & Medicine. Dec2008, Vol. 15 Issue 3, p213-225. 13p. |
| Abstract: | Increasing HIV testing is a necessary step toward control of the disease. Many experts suggest routinely offering HIV testing to specific population segments. We explore provider discourse regarding an HIV test implementation project with the aim of illuminating a structurally emergent clinician strategy for promoting testing and the socio-cultural factors underlying it. Twenty US Veterans Affairs Healthcare System clinical care providers were interviewed. Using standard anthropological text analysis techniques, themes, their relationships, and the significance of these for increasing appropriately targeted HIV test offers were established. Presenting the HIV test offer to their patients as if routine ('routinisation') supported providers' desire to do no harm by lessening the test's potential stigma. Offering the test helped providers maintain professional integrity: it empowered veterans to realise access to care and fit with providers' sense of honour and duty. Routinising HIV testing also helped providers to manage scarce time effectively. Findings can be leveraged to support routine screening's successful roll-out. The carefully managed introduction of routine HIV test offering policies will formalise and legitimise productive strategies of destigmatisation already being enacted by some front-line providers. The fact that routinisation strategies are in use although HIV testing is not actually routine attests to the potential power routinisation has to reduce HIV's stigma, increase HIV test uptake, and thereby improve access to care. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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