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Opt-in HIV testing in construction workplaces: an exploration of its suitability, using the socioecological framework

Somerset, Sarah; Jones, Wendy; Evans, Catrin; Cirelli, Cecilia; Mbang, Douglas; Blake, Holly

Opt-in HIV testing in construction workplaces: an exploration of its suitability, using the socioecological framework Thumbnail


Wendy Jones

Professor of Evidence Based Healthcare

Cecilia Cirelli

Douglas Mbang

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Professor of Behavioural Medicine


Background: Late diagnosis of HIV remains a challenge, despite improved testing and treatment. Testing is often targeted at high-risk groups; workplace events might normalise testing and allow access to a wider population. The construction workforce has a number of risk factors for HIV. In the Test@Work study, HIV tests were delivered within general health checks to construction employees, with high uptake and acceptability. This paper reports on the experiences of construction managers and health professionals involved in Test@Work and explores the suitability of construction worksites as a venue for opt-in HIV testing. Methods: Qualitative interviews (n= 24) were conducted with construction managers who had facilitated health check/HIV testing (n= 13), and delivery partners (n= 11) including i) healthcare volunteers who had delivered general health checks (n= 7) and, ii) HIV professionals who had conducted HIV testing (n= 4) at 21 Test@Work events held on construction sites. Interviews explored their experiences of these events and views towards HIV testing in the workplace. Exit questionnaires (n= 107) were completed by delivery partners after every event, providing qualitative data identifying facilitators and barriers to effective delivery. Thematic analysis identified themes that were mapped against a socioecological framework. Results: Delivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing. HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk. Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities. Conclusions: The construction sector is complex with a largely male workforce. Providing worksite HIV testing and education to an untested population who have poor knowledge about HIV risk helped to normalise testing, encourage uptake and reduce HIV-related stigma. However, there are practical barriers to testing in the construction environment. Rapid testing may not be the most suitable approach given the challenges of maintaining confidentiality on construction worksites and alternatives should be explored.

Journal Article Type Article
Acceptance Date Jun 6, 2022
Online Publication Date Jul 23, 2022
Publication Date Jul 23, 2022
Deposit Date Jun 8, 2022
Publicly Available Date Jul 23, 2022
Journal BMC Public Health
Electronic ISSN 1471-2458
Peer Reviewed Peer Reviewed
Volume 22
Issue 1
Article Number 1409
Public URL
Publisher URL


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