Overcoming the barriers and challenges to HIV testing

In the dropdowns below you'll find information and exercises to share with your team.

Before going to these, have a look at the downloadable preparation and running the session instructions.

When you have done your preparation, choose from the links below to find exercises and strategies for your team.

Lack of time!
Every team will have this on their list. On the one hand – of course we lack time. The pressures in, and on, primary care are enormous. There is no exercise that will overcome this! However, on the other, there are often underlying issues. We would never fail to measure a blood glucose, if concerned, through lack of time. So is lack of awareness of the benefits of HIV testing actually to blame? Or embarrassment in raising the topic? Or simply a lack of time-efficient strategies to test?

We know that practices can substantially increase their HIV testing rates in response to training without giving them time (or even financial incentive). So: time may remain as a barrier the team leaves on the list, but they should understand that it is only part of the story.
Communication difficulties...
...such as difficulty raising the subject of HIV. There are many barriers and challenges around communication. You'll find many on the Barriers and challenges page. We've also listed some on this exercise to help your team identify communication strategies.

You'll need this too to run the exercise: SHIP useful phrases.

Fears about lack of knowledge or skills: confidence
These are sometimes to with lack of confidence in ability to discuss HIV testing (or give results).

There are many barriers and challenges around knowledge and confidence. You'll find many on the Barriers and challenges page. We've also listed some on this exercise to help your team increase confidence in offering HIV tests.

Fears about lack of knowledge or skills: clinical
Some barriers and challenges are to do with a lack of clinical knowledge. Many are listed on the Barriers and challenges page.

Most, if not all, of these barriers should have been addressed in earlier exercises.

Have a look at the two slidesets: The case for HIV testing and Diagnostic testing for HIV.

Have a look also at HIV in primary care.

THE RCGP curriculum e-learning (e-GP) has several e-learning sessions which will help GPs to improve thier clinical knowledge in an interactive way.

Lack of awareness of the benefits of HIV testing
Some barriers and challenges are to do with a lack of awareness of the benefits to patients of HIV testing. You'll find many on the Barriers and challenges page. Some are included on this exercise to help your team understand the benefits of HIV testing.

Concerns about confidentiality or insurance
Some barriers and challenges are to do with a variety of issues such as confidentiality or insurance. You'll find many on the Barriers and challenges page. Some are also included on this information sheet.
I can't find a matching group!
You may have found there are barriers you could not classify.

Did any of them appear on the Barriers and Challenges page?

For each one of these: think through for yourself why these barriers have been selected.

Are they to do with patient fears and concerns?

If so, the Feel Free to Ask exercise – and implementation of changes may help. Review how your team did with this.

Or do they relate more closely to doctor or nurse concerns?

Ask your team to work in 2s or 3s.
What can we do to overcome this challenge?

Each group to come up with one or two ideas.

List on flip chart and discuss.








Did you know...

Antiretrovirals were initially used singly however it quickly became apparent that this led to resistance and so now they are used in combinations of 3 or more.

The first HIV antibody test became widely available in 1985, current venous sample tests are for HIV1 and 2; both antibody and antigen.

Doctors