Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare

Int Health. 2019 Mar 1;11(2):93-100. doi: 10.1093/inthealth/ihy077.

Abstract

Background: Acute HIV infection (AHI) is the phase of HIV infection immediately after acquisition, during which many patients develop symptoms and often seek healthcare. However, clinicians in sub-Saharan Africa are not currently taught about AHI.

Methods: This study pilot-tested a self-directed AHI training module among clinical officers (COs) in coastal Kenya and assessed knowledge gained and challenges to instituting screening. The training module included four domains: AHI definition and importance of AHI recognition; symptoms and screening algorithms; diagnostic strategies; and management. AHI knowledge was assessed before and immediately after training. Participants' ability to utilize an AHI screening algorithm was evaluated with a case-based exercise.

Results: Self-directed training was completed by 45 COs. Pre-test scores were low (median score 35% IQR 30-45%), but improved significantly after training (median post-test score 75%, IQR 70-85%, Wilcoxon signed-rank test p<0.0001). Participants had challenges in understanding the utility and application of a screening algorithm to identify patients for whom AHI testing would be indicated. Knowledge of AHI was poor at baseline, but improved with self-directed learning. Based on these findings, we revised and improved the AHI training module and pre- and post-assessments, which are now freely available online at www.marps-africa.org.

Conclusions: Guidelines on AHI screening and diagnosis are urgently needed in high HIV transmission areas.

Keywords: acute HIV infection; febrile patient; online learning; screening algorithm; self-directed learning.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Algorithms
  • Ambulatory Care / statistics & numerical data
  • Clinical Competence / statistics & numerical data
  • Education, Distance*
  • Female
  • HIV Infections / diagnosis*
  • Humans
  • Kenya
  • Male
  • Mass Screening*
  • Patient Acceptance of Health Care
  • Physicians, Primary Care / education*
  • Physicians, Primary Care / statistics & numerical data
  • Pilot Projects
  • Young Adult