Routine HIV testing in the context of syndromic management of sexually transmitted infections: outcomes of the first phase of a training programme in Botswana

Department of Health Services, University of Washington, 901 Boren, Seattle, WA 98104, USA.
Sexually transmitted infections (Impact Factor: 3.4). 02/2008; 84(4):259-64. DOI: 10.1136/sti.2007.028217
Source: PubMed


In 2004, the Ministry of Health adopted revised protocols for the syndromic management of sexually transmitted infections (STI) that included routine HIV testing. A training programme for providers was developed on the revised protocols that featured interactive case studies and training videos. An objective of the first phase of the training programme was to test its effect on four measures of clinical practice: (1) routine HIV testing; (2) performance of physical examination; (3) risk-reduction counselling and (4) patient education.
Clinical practice in a district where providers were trained was compared with a district without training. The measures of clinical practice were reported by 185 patients of providers who had been trained and compared with reports by 124 patients at comparison clinics.
Relative to patients at comparison clinics, a higher percentage of patients of trainees reported that the provider: (1) offered an HIV test (87% versus 29%; p<0.001); (2) conducted a physical examination (98% versus 64%; p<0.001); (3) helped them to make a plan to avoid future STI acquisition (95% versus 76%; p<0.001) and (4) provided patient-specific information about HIV risk (65% versus 32%; p<0.001). Among patients offered HIV testing, the percentage who accepted did not differ between groups (38% of 161 patients of trainees versus 50% of 36 comparison patients; p = 0.260). Overall, 33% of patients of trainees and 14% of comparison patients were tested (p<0.001).
A multifaceted training programme was associated with higher rates of HIV testing, physical examination, risk-reduction counselling and better HIV risk education.

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Available from: Marcia R Weaver, Oct 04, 2015
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    • "Video is currently used as an education tool in the health field in numerous facets: in preventive health measures [2], [3], [4], [5]; to teach medical students and practitioners new procedures [6], [7], [8], [9]; to demonstrate interventions [10], [11]; to improve counseling skills [12], [13], [14]; and to deliver health information to the patient [15], [16]. A review of the literature identified one article that addressed the influence of demonstration videos on the students' perspective on the counseling profession [17]. "
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    ABSTRACT: Interest in integrative health care is a growing area of health practice, combining conventional medical treatments with safe and effective complementary and alternative medicine. These modalities relate to both improving physical and psychological well-being, and enhancing conventional talk therapy. In an interdisciplinary collaboration, teaching and library faculty have created a series of sixteen on-line video interviews that introduce practitioner-relevant experiences to students as supplemental course material. These videos are available through the department web-pages to students in other related disciplines as well, including Social Work, Counselor Education, Psychology, and the Colleges of Public Health, Nursing, and Medicine. The video series was undertaken as part of the educational mission of the library, bringing to the classroom new material that is essential to the professional development of future counselors.
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    • "The evidence for PITC with STI patients is limited to a few quasi-experimental studies in the UK and the Netherlands [20,21,25,26], and one controlled trial in Sub-Saharan Africa [27]. The European trials report significant increases in HIV testing for STI patients, although a recent UK study with low-risk STI patients showed that there was a significant increase in the offer of testing, not in the proportion of patients who accepted testing [28]. "
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    International Journal for Quality in Health Care 01/2012; 24(2):152-60. DOI:10.1093/intqhc/mzr080 · 1.76 Impact Factor
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