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Universal HIV testing in London tuberculosis clinics: a cluster randomised controlled trial

Roy, A; Anaraki, S; Hardelid, P; Catchpole, M; Rodrigues, LC; Lipman, M; Perkins, S; ... Abubakar, I; + view all (2013) Universal HIV testing in London tuberculosis clinics: a cluster randomised controlled trial. European Respiratory Journal , 41 (3) pp. 627-634. 10.1183/09031936.00034912. Green open access

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Abstract

We assessed whether implementation of a combination of interventions in London tuberculosis clinics raised the levels of HIV test offers, acceptance and coverage. A stepped-wedge cluster randomised controlled trial was conducted across 24 clinics. Interventions were training of clinical staff and provision of tailor-made information resources with or without a change in clinic policy from selective to universal HIV testing. The primary outcome was HIV test acceptance amongst those offered a test, before and after the intervention; the secondary outcome was an offer of HIV testing. Additionally, the number and proportion of HIV tests among all clinic attendees (coverage) was assessed. 1,315 patients were seen in 24 clinics. The offer and coverage of testing rose significantly in clinics without (p = 0.002 and p = 0.004, respectively) and with an existing policy of universal testing (p = 0.02 and p = 0.04, respectively). However, the level of HIV test acceptance did not increase in 18 clinics without routine universal testing (p = 0.76) or the six clinics with existing universal testing (p = 0.40). The intervention significantly increased the number of HIV tests offered and proportion of participants tested, although acceptance did not change significantly. However, the magnitude of increase is modest due to the high baseline coverage.

Type: Article
Title: Universal HIV testing in London tuberculosis clinics: a cluster randomised controlled trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/09031936.00034912
Publisher version: http://dx.doi.org/10.1183/09031936.00034912
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Respiratory System, HIV, implementation of policy, information resources, raising awareness, HEALTH-CARE SETTINGS, EMERGENCY-DEPARTMENT, OPT, EPIDEMIOLOGY, INFECTION, RATES, COINFECTION, ACCEPTANCE, ENGLAND, ALBERTA
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1356339
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