Factors impacting HIV testing: a review – perspectives from Australia, Canada, and the UK

Bolsewicz, K., Vallely, A., Debattista, J., Whittaker, A. and Fitzgerald, L. (2015) Factors impacting HIV testing: a review – perspectives from Australia, Canada, and the UK. AIDS Care, 27 5: 570-580. doi:10.1080/09540121.2014.986050

Author Bolsewicz, K.
Vallely, A.
Debattista, J.
Whittaker, A.
Fitzgerald, L.
Title Factors impacting HIV testing: a review – perspectives from Australia, Canada, and the UK
Journal name AIDS Care   Check publisher's open access policy
ISSN 0954-0121
Publication date 2015-01-01
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1080/09540121.2014.986050
Volume 27
Issue 5
Start page 570
End page 580
Total pages 11
Place of publication Abingdon, Oxon, United Kingdom
Publisher Routledge
Language eng
Formatted abstract
With the current global focus on strengthening HIV prevention through greater testing and treatment uptake, it is increasingly salient to identify and address barriers to testing. A review of the published, peer-reviewed literature and national reports from Australia, Canada, and the UK (2003–2013) on barriers to HIV testing was conducted to provide new information relevant to Australia and to complement earlier reviews from Canada and the UK. A systematic database search using keywords and a set of inclusion criteria yielded 36 studies (Australia = 13; Canada = 6; and the UK = 17). In addition 17 unpublished reports were included in the review. Our study uses a novel, comprehensive framework to describe barriers to HIV testing, and thus contributes to moving beyond the traditional patient–provider–system categorization. Within that framework, barriers are categorized as either intrapersonal (reported in 15 studies), interpersonal (21), or extrapersonal (16) and conceptualized within wider sociocultural and structural contexts. People's abilities and motivations to test (intrapersonal factors) are influenced by a host of interconnected factors spanning relationship (interpersonal) and broader socioeconomic, political and cultural (extrapersonal) factors. We suggest that the relative effects of interventions targeting barriers to HIV testing at the intrapersonal and interpersonal levels are limited by the extent to which the social determinants of health are addressed. The framework may also lend itself to thinking about the enabling factors for HIV testing, and future research may investigate the application of that framework for strategizing the most effective response. Future studies should also capture the lived experiences of barriers to HIV testing experienced by patients, especially in populations which are hard to reach based on social and geographic distance. Context-specific studies to evaluate the feasibility and effectiveness of various interventions proposed in the literature to address barriers to HIV testing are needed.
Keyword HIV testing
United Kingdom
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
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Created: Tue, 09 Dec 2014, 23:15:46 EST by Kasia Bolsewicz on behalf of School of Public Health