June 29, 2019
2 min read

Office social norms predict nurse practitioner HIV screening behavior

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Jodi L. Sutherland, PhD, RN, ACRN
Jodi L. Sutherland

Survey results suggested that nurse practitioners who work in offices where the staff is supportive of routine HIV screening are more likely screen patients for infection.

Writing in the Journal of the Association of Nurses in AIDS Care, researchers said that medical practices should consider HIV social norms as a “mediator to increase screening rates.”

“We found that the strongest predictor of nurse practitioner HIV screening behaviors was social normative expectations, followed by beliefs regarding routine HIV screening,” Jodi L. Sutherland, PhD, RN, ACRN, clinical assistant professor at the Decker School of Nursing at Binghamton University, told Infectious Disease News.

Sutherland and colleagues conducted the cross-sectional survey in 2014, analyzing responses from 141 members of the American Association of Nurse Practitioners. They used 46 questions to evaluate factors contributing to participants’ beliefs, and the amount of routine HIV screening they conducted.

The majority of participants were female (92.2%; n = 130), white (88.7%; n = 125), aged 50 to 59 years (39%; n = 55) and worked in primary care (43.3%; n = 61) or at a community clinic (18.4%; n = 26), the researchers reported.

Around 25% (n = 35) of respondents reported routine HIV screening, and three attitudinal beliefs were significantly associated with screening behaviors, according to the findings. These were: “agreement that offering routine HIV screenings to all patients regardless of risk will benefit my patients;” “agreement that consent from parent/guardian should be obtained;” and “agreement with the 2013 Coverage Guide for HIV.”

Two social normative expectation beliefs — “colleagues assume I would discuss HIV with concerned patients” and “my office staff supports my routine HIV screening even when it takes more time” — were significantly related to increased nurse practitioner screening behaviors, the researchers reported.

They found that nurse practitioners with HIV screening behaviors reported few barriers. For those without HIV screening behaviors, seven belief items were statistically significant concerning barriers, including items related to agreement with “having confidence in HIV knowledge” and “difficulty in screening when accompanied by a guardian/spouse/third-party person,” they wrote.

Sutherland and colleagues concluded that the items with the most statistical significance were “my office staff supports routine HIV screening with my patients even when it takes more time” (OR = 1.79; 95% CI, 1-3.1), which was associated with more HIV screening; and “consent from a parent/guardian should be obtained before screening for HIV in a person younger than 18 years” (OR = 0.61; 95% CI, 0.4-1), which was associated with less HIV screening.


The results were published ahead of National HIV Testing Day.

“We want to encourage health care providers to discuss HIV screening at every patient visit,” Sutherland said. “For patients between the ages of 13 and 64 who have never been tested, it is recommended that they get tested at least once in their lifetime.”

The researchers said providers who care for patients in this age group should review current intake practices and HIV screening procedures, and that improved consent procedures are needed for patients aged 18 years or younger. – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.