Qualitative evaluation of an education intervention for healthcare professionals on appropriate HIV testing in higher prevalence general practices in a city in the southwest of England

Introduction Approximately 25% of people infected with HIV are undiagnosed. Late diagnosis occurs in up to 50% and has negative consequences for patients, public health and the NHS. To encourage appropriate HIV testing, Bristol City Council commissioned an education intervention in GP-practices. This qualitative study examined healthcare professionals’ (HCPs) experiences and perceived impacts of the education intervention on HIV testing. Methods Education sessions (~1-hour) based on the MEDFASH ‘HIV testing in practice’ online educational tool were delivered as a stepped-wedge randomised controlled trial in 19 Bristol GP-practices with a high HIV practice population prevalence (>2/1000). Semi-structured interviews were conducted with HCPs who attended the training approximately 3-months post-training, and the sexual health clinician that delivered the training. Interviews explored pre-training HIV testing practices, factors influencing testing, views of the training, impact on knowledge, confidence and testing practices. GP-practices were reimbursed £40 per interview. Interviews were audio recorded, transcribed verbatim and analysed thematically. Results 27 interviews (lasting 30minutes on average) were conducted across 13 practices with 16 GPs, 10 nurses and the sexual health clinician. Participants appreciated the opportunity to update their HIV knowledge through a tailored, interactive session, delivered by a knowledgeable sexual-health clinician. Post-training, HCPs increased: awareness of HIV indicator conditions; confidence/self-efficacy to offer HIV tests efficiently; and consideration of HIV tests. Whilst some felt they had increased HIV testing others did not. Continued barriers to testing include perceived lack of opportunity and considering HIV during consultations. To optimise intervention impact, follow-up sessions were recommended. Discussion The findings suggest the HIV training was experienced positively and improved perceived awareness, confidence, and consideration of HIV testing whilst perceptions of testing rates were mixed. This study highlights that HIV education is perceived as valuable for increasing awareness of HIV testing opportunities but repetition may be needed to sustain its impact.