HIV/AIDS Case-Finding In Family Planning Clinics

1. HIV/AIDS Case-FindingIn Family Planning Clinics Midwest AIDS Training & Education Center Health Care Education & Training, Inc.

2. Section 2:Missed Opportunities for Testing

3. Objectives for Section 2 • Identify the types of health care providers who diagnose HIV • Determine who initiates testing • Define a “missed opportunity” for testing and diagnosis • Examine some studies documenting missed opportunities for testing

4. Health Care Providers Diagnosing HIV Infection

5. PACTG 367 n=1,527 pregnancies Timing of HIV Diagnosis Role of Reproductive Health Care Practitioners in Diagnosing HIV

6. Who Initiates Testing? In one study …. In this study, 8 providers denied testing to women who specifically asked to be tested

7. Definition of “Missed Opportunity” Missed Opportunity = An encounter with a health care provider for any reproductive health issue—regardlessof risk factors or any contact with any other HCP—by a patient engaging in high-risk behavior where testing was not performed. —MacDonald et al., 1998

8. Key Findings in the MacDonald Study • 73 of 81 women had had 116 health care encounters • 75% of those encounters were missed opportunities • 80% of the women had at least one missed opportunity in 12 months before diagnosis • 78% had missed opportunities at reproductive health encounters

9. Avoiding Missed Opportunities • To avoid any missed opportunities, the family planning clinic should: • Offer HIV testing to all women using clinic services • Perform risk reduction counseling with all clients when offering the test • Encourage retesting as needed, as a positive step in managing one’s health