Understanding The Patient's Perspective on Rapid and Routine HIV Testing in an Inner City Urgent Care Center, Angela B. Hutchinson et al., 16 AIDS Education and Prevention 101 (2004)

This study explored patient perspectives on rapid and routine HIV testing among primarily minority patients in an urgent care center at an urban public hospital. The results, broken down by gender, reveal the importance of voluntary testing, counseling, and confidentiality to patients considering getting tested. Reasons cited for not getting tested focused mainly on fear, stigma, and discrimination, as well as concerns about the confidentiality of test results. Patients also cited significant concern about time and cost that acted as deterrents to testing. For many patients, what providers might consider nominal costs were in fact prohibitively expensive, and the “rapid” testing often involved hours of waiting, creating an additional deterrent. Patients also expressed distrust of health care providers and concerns that they would be tested without their consent. The study also revealed several misconceptions about HIV and HIV testing that underscore the importance of counseling in the context of testing. If one accepts HIV testing as a gateway to care, and patient health literacy and engagement in treatment as central to that care, then this study suggests that counseling and communication that breaks down mistrust and misunderstanding at the time of HIV testing is vital.