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More training needed to encourage practice nurses to offer HIV tests

Practice nurses need more training and better support to increase rates of HIV testing, researchers have recommended.

One-off training sessions on HIV testing are not enough to promote behaviour change in general practice staff, researchers have found, and additional strategies, such as computer prompts, may needed to increase testing rates.

Researchers from the University of Bristol looked at the impact of a one-hour training workshop on HIV testing, delivered in 19 different general practices by a sexual health doctor. The session included case studies and discussion on improving HIV testing rates in the practice.

In an initial quantitative evaluation, researchers found that there was an increase of just under 2% in the number of HIV tests ordered by practices in the six months after the training. This was, however, similar to the increase seen in control practices who did not receive the training, and likely just a general trend rather than attributable to the intervention.

They found during qualitative interviews that nurses perceived the training as positive and felt more empowered to offer testing without asking a GP for permission first, but the fact that it was a one-off session made it difficult to remember the key messages. They also felt that the training lacked focus on clinical skills and didn’t address barriers such as time constraints.

Those interviewed suggested that more case-studies and role-playing would help improve the intervention and that it needed to be reinforced in other ways, such as having follow-up sessions and system changes, like computer prompts to offer testing.

Dr Jo Kesten, lead author and senior research associate at the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, said: ‘Increasing the uptake of HIV testing across healthcare settings and reducing the stigma surrounding HIV testing is a major priority.

‘A single educational workshop on HIV testing, although experienced positively, is likely to require repetition and support from additional measures to help encourage increased HIV testing rates. Our research highlights several continued barriers to testing suggesting that more support is needed to increase clinicians’ motivation and opportunity for HIV testing in primary care.’