Referral and referral facilitation behavior of family planning providers for women with HIV infection in the southern United States.

BACKGROUND: Many women receive family planning (FP) services from federally supported FP providers. These FP services include testing for sexually transmitted infections (STD), including the human immunodeficiency virus (HIV). FP providers are expected to refer patients with non-FP conditions, including HIV, to other providers for treatment. Prompt HIV treatment improves outcomes and survival, yet many women face barriers to accessing treatment. Facilitation of referrals improves referral follow-up. However, little is known about the referral practices and facilitation activities of FP providers for their clients testing positive for HIV.
METHODS: To fill this gap, this article reports the findings of a study that used a mail survey of FP providers (n = 456) to document referral practices and facilitation activities when providers see HIV-positive patients.
RESULTS: The study found that nearly all FP providers report referring HIV-infected clients to another provider rather than providing treatment themselves. Factors associated with significantly more facilitation of referrals included perception of less competent patients, perception of more referral resources, personal relationships with referral providers, rural locality, and information support staff.
CONCLUSIONS: Some factors associated with low facilitation (such as perception of few referral resources and no personal relationships with referral providers) are amenable to change. Interventions targeting these factors should be designed and tested to increase facilitation of referrals and the follow-up with referrals for HIV treatment.