Pediatric primary care providers in Philadelphia: An assessment of HIV testing and prevention education practices, barriers to care delivery, and HIV awareness

Abstract

Objectives. To determine the extent of HIV prevention education and HIV testing delivered to adolescents (ages 13-21); to determine clinician-identified barriers to their delivery of HIV care to adolescents; and to determine clinicians' awareness of HIV standards of care, rapid testing technology, and common HIV transmission modes. Design. A voluntary, confidential, self-report questionnaire was distributed to a convenience sample of 134 pediatric primary care providers (PCPs). Sample design utilized provider contact information from eight Internet-based health care directory websites. Participants. Pediatric PCPs (MDs, DOs, PAs, and NPs) in Philadelphia. Results. The 36 respondents discussed HIV prevention with 66% of their patients and offered HIV testing to 45%. Time constraints and Pennsylvania-mandated pre/post-test counseling and separate written consent were commonly identified barriers to HIV care delivery. Provider awareness of CDC recommendations for routine HIV testing was significantly related to more frequent care delivery, yet many clinicians were unaware of current standards of HIV care. Limitations. The sample was modest in size and convenient in nature. As such, results may not be generally applicable to all pediatric PCPs in Philadelphia. Conclusions. Numerous opportunities for HIV testing and prevention education are missed by pediatric PCPs. The reconciliation of CDC HIV testing recommendations and Pennsylvania's Confidentiality of HIV-Related Information Act (Act 148) may alleviate several provider-identified barriers to care delivery. Educational initiatives for pediatric PCPs regarding HIV testing and HIV prevention education should be developed and implemented.