'So, on what basis do you think that staff in general practices should offer or recommend an HIV test to their patients?'
'A lot of the time here, it’s on patient request. Um, if there’s needle or stick injury for staff and, you know, any patients that think they’ve come into contact with, or at risk of. Um, I think it should be more widely tested, but again, it’s done to cost and practicalities.'
'What’s the practicality bit for you?'
' ... well doesn’t it take a long, long time to get it back? And it’s very costly, um, is that my perception.' (Nurse ER95B, pre-intervention, high prevalence)
'[Discussing when they would offer an HIV test] We were screening opportunistically as well for people that were coming in for the sexual health checks um, I think we still need to do better. I think, at the moment, when the surgery thinks sexual health checks they think swabs, for women, and they’re not thinking what we’re doing for men, and thinking that, maybe, we should be routinely offering to anyone ... I think we definitely need to do more HIV side, yeah.' (Nurse KTPN17F, pre-intervention, high prevalence)
'How do you think the patients feel about being recommended an HIV test?'
'I still think there’s a lot that would be probably quite shocked that we were recommending that.' (Nurse YORA1, post-intervention, low prevalence)
'Do you know what the response is with that? Do people say yes, no?'
'Certainly the ones I see in consultation, 99% say "yes, have the bloods done for my testing".' (GP YORA4, post-intervention, low prevalence)
'I do, I suppose I would offer it differently to the GP. So I’d offer it as part of the sexual health screening, so if someone’s having a smear done and I say, "would you be interested in a sexual health screen?" then we’d talk about the differences of swabs or the blood borne viruses. It’s interesting that a lot will want chlamydia check but aren’t interested in any of the blood borne virus.' (Nurse KTPN15K, pre-intervention)
'You’ve got the patient in, you test them and wait 20 minutes for the result, and then after the result, you’ve got to chat to them about the results. That’s not just 20 minutes, that time is a lot, lot longer … Doctors get 7–10 minutes per patient and we get 15 minutes, so I don’t think our appointments can accommodate.' (Nurse KTPN97A, pre-intervention, low prevalence)
'[Discussing POCTs] If was accurate, which they’re supposed to be, aren’t they? ... I suppose my concern would be that, that the back-up, you know, there was availability, somebody from GU to talk to them and follow them up fairly swiftly … Doing that on somebody that’s high risk, that’s the problem with these things, isn’t it, they’re all fine and dandy when they’re all negative, but if you’ve got a, yeah, a positive in the middle of a morning surgery, you haven’t got an hour to sit with them and discuss the ins and outs and all the rest of it. So that, that would be my concern, thought, you know, the back-up if you have a positive result.' (GP ER49, pre-intervention, high prevalence)
'Any thoughts of using POCTs? If you were given them free?'
' … Well, I wouldn’t feel particularly confident in the results there for me to deliver … And it’s not something I, kind of, trained, or would want to do … I think it’s an absolutely, it’s one of the biggest life-changing events, isn’t it? ... So it just feels outside of my depths to be honest.” (Nurse KTPN15K, pre-intervention, high prevalence)
'If you’re sending anyone for HIV, you would generally do a hepatitis as well … so if, if I’m going to do the point of care for HIV, I still have to send them for the hepatitis, so that doubles my work. So I would still send them for the blood test.' (GP KT8A, pre-intervention, high prevalence)
'[Discussing POCTs] I think they’re fantastic. Yeah, because … half the problem is … like you do a pregnancy test, isn’t it? If you do pregnancy test for somebody, you say, "give me your urine and then I’ll see you in a week". You know, the anxiety that they are going through. Whereas, if you’ve got to deal with it there and then, as long as you’re doing it and the, you’ve done the build up to it. I think it’s a good thing.' (GP KTGP30J, pre-intervention, low prevalence) |