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Making HIV testing work at the point of care in South Africa: a qualitative study of diagnostic practices

Overview of attention for article published in BMC Health Services Research, June 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)

Mentioned by

1 policy source
20 tweeters
2 Facebook pages


18 Dimensions

Readers on

105 Mendeley
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Making HIV testing work at the point of care in South Africa: a qualitative study of diagnostic practices
Published in
BMC Health Services Research, June 2017
DOI 10.1186/s12913-017-2353-6
Pubmed ID

Nora Engel, Malika Davids, Nadine Blankvoort, Keertan Dheda, Nitika Pant Pai, Madhukar Pai


Point of care testing promises to reduce delays in diagnosing and initiating treatment for infectious diseases such as Human Immuno-deficiency Virus (HIV). In South Africa, decentralized HIV testing with rapid tests offers important lessons for point of care testing programs. Yet, little is known about the strategies of providers and clients to make HIV testing successful in settings short of equipment, human resources and space. We aimed at examining these strategies. This paper is based on a larger qualitative study of diagnostic practices across major diseases and actors in homes, clinics, communities, hospitals and laboratories in South Africa. We conducted 101 semi-structured interviews and 7 focus group discussions with doctors, nurses, community health workers, patients, laboratory technicians, policymakers, hospital managers and manufacturers between September 2012 and June 2013 in Durban, Cape Town and Eastern Cape. The topics explored included diagnostic processes and challenges, understanding of diagnosis, and visions of ideal tests. For this paper, the data on HIV testing processes in clinics, communities and hospitals was used. Strategies to make HIV testing work at point of care involve overcoming constraints in equipment, spaces, human resources and workload and actively managing diagnostic processes. We grouped these strategies into subthemes: maintaining relationships, adapting testing guidelines and practices to stock-outs, to physical space, and to different clients, turning the test into a tool to reach another aim and turning the testing process into a tool to enhance adherence. These adaptive strategies are locally negotiated solutions, often ad-hoc, depending on personal commitment, relationships, human resources, physical space and referral systems. In the process, testing is redefined and repurposed. Not all of these repurposing acts are successful in ensuring a timely diagnosis. Some lead to disruptions, unnecessary testing or delays with at times unclear implications for quality of diagnosis. Tests shape relationships, professional roles and practices of users at point of care. At the same time, testing processes are dynamic and test results and processes take on new meanings for clients and providers. These insights are crucial for understanding the contexts within which diagnostic devices and policies need to function.

Twitter Demographics

The data shown below were collected from the profiles of 20 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 105 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 23%
Researcher 18 17%
Student > Ph. D. Student 12 11%
Student > Bachelor 11 10%
Other 5 5%
Other 17 16%
Unknown 18 17%
Readers by discipline Count As %
Medicine and Dentistry 20 19%
Nursing and Health Professions 16 15%
Social Sciences 13 12%
Agricultural and Biological Sciences 5 5%
Psychology 4 4%
Other 19 18%
Unknown 28 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2021.
All research outputs
of 21,751,441 outputs
Outputs from BMC Health Services Research
of 7,244 outputs
Outputs of similar age
of 289,082 outputs
Outputs of similar age from BMC Health Services Research
of 4 outputs
Altmetric has tracked 21,751,441 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,244 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.5. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 289,082 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.