Why do patients refuse HIV testing in the emergency department? Perspectives from a qualitative study

ABSTRACT

Despite support for routine testing in all health care settings, including emergency departments (EDs), there are challenges to implementing ED-based HIV testing and high refusal rates. We conducted qualitative interviews to examine reasons for refusal with 30 testing refusers in the ED of a safety net hospital. Key themes included: routine testing is positive, importance of privacy and respectful approach, ED atmosphere and environment discourage testing acceptance, importance of HIV counseling, desire to see an MD before testing staff, and who should offer testing. Results provide useful information for programs and policies of routine ED-based HIV testing to encourage testing uptake.

KEYWORDS:

• emergency department
• HIV infection
• HIV testing

Acknowledgments

The authors would like to acknowledge Randie Kutzen and Jonathan Hall for their help in management of HIV testing staff, Shuo Cheng Lin for assistance with recruitment, and Jacqueline Ellison. The authors would also like to acknowledge the HIV testers: Kimberley Barrett, David Russell, Oscar Soto, and Jamila Scott.

Statement

This manuscript has not been published elsewhere and has not been submitted for publication elsewhere.