This is attributed to clients' passivity to seek testing, refusal of testing offer, and lack of an active role of providers to initiate testing.
Despite the protocol allowing nurses to initiate testing, five nurses commented that they continued to make decisions about testing in consultation with the urologist; some variation in nurses initiating tests or hospital admission was attributed to local hospital trust policy.
By 2010, 32 of 38 countries with generalized HIV epidemics had national guidelines advising health care providers to initiate testing and counseling in all clinical encounters [ 6].
First, GPs may have been more likely to initiate testing, knowing the nurse was available to carry out the tests, without testing impacting on their own consultation time [ 19].
However, there are also barriers associated with VCT participation, which include clients having to initiate testing themselves, lengthy pre- and posttest counseling, and patient concerns about confidentiality [ 8, 9].
This difference was probably due to programme initiated testing, which leads to extra tests within one to two years after the index screen (that is, at 2-3 years from the start of follow-up).
The cells were left to incubate overnight prior to initiating the test.
Systems that permit PNs to initiate chlamydia testing, along with modifications to clinic testing pathways so young people were seen by the PN first, without direct input from a GP, could also address the barrier of time and workload pressures, which was commonly raised and consistent with earlier GP studies on chlamydia testing in the United Kingdom [ 35, 36] and Australia [ 37, 38].
We have pooled the three ancestral mutations in our analyses, because if a woman has a sufficiently high probability of being a carrier to initiate mutation testing, the extra work and expense to test for all three mutations is relatively small given that she will have already gone through counselling and provided a blood sample from which DNA had been extracted.
For pregnant women testing HIV-positive, intended practice at the sites was to initiate CD4 testing by having blood drawn and sent to the laboratory and to receive a 4-week supply of AZT prophylaxis (if at least 14 weeks gestation) from the ANC nurse.
