Public and Healthcare Practitioner attitudes towards HIV testing: A review of the evidence in the UK

Aims: To explore attitudes towards HIV testing in the United Kingdom (UK) from the public and healthcare practitioners (HCP) to more fully understand the barriers and motivators towards testing.

Methodology: Electronic databases Pubmed, Web of Science, OVID Medline and Google were searched. We included studies conducted in the UK that had explored public and HCP attitudes towards HIV testing, published in the combination antiretroviral therapy era (1996-2014). We excluded studies relating to HIV testing or screening of pregnant women.

Results: In a total of 64 studies identified, 41 and 23 were on positive and negative attitudes towards HIV testing of the public and HCP, respectively. Common barriers reported by the public were stigma, fear, denial, and low perception of risk. Common barriers reported by HCP were lack of confidence or anxiety around offering a test, privacy and confidentiality, and insufficient knowledge/training in HIV. Public motivators towards testing were: HCP offering/recommending a test, universal testing at practice registration, outreach rapid point-of-care (POC) testing offered as part of a check-up, availability of home testing/sampling, and informing patients about HIV and the benefit of receiving treatment.

Conclusions: Recommendations to overcome barriers include making HIV testing routine, easier and more accessible. Outreach POC testing, home testing and sampling offer motivators to testing such as ease of access, privacy and confidentiality. A proactive offer of an HIV test by the HCP is an important factor which could help increase testing rates. This could be facilitated by further education and training of HCP in General Practice.