Odhiambo J, Nganga L, Wambua N, Mburu M, DeCock K, Kizito W, Njoroge A, Manwari C, Edward P, Chakaya J, Tanui I; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. MoPeB3227.
Centers for Disease Control & Prevention, Nairobi, Kenya
Issues: Voluntary counseling and testing (VCT), a widely advocated HIV/AIDS prevention strategy, targets largely healthy adults. In sub-Saharan Africa, up to 70% of patients with smear + pulmonary TB are HIV+ and up to half of people living with HIV/AIDS develop TB. Such strong associations, plus the need to provide comprehensive care and prevent new HIV transmissions, offer compelling reason for testing TB patients for HIV. This is diagnostic counseling and testing(DCT) which targets the sick. Stigma associated with the TB-HIV link must be recognized and addressed. Description: DCT was offered to all newly diagnosed TB patients attending a demonstration facility (St Vincent Clinic) delivering integrated TB and HIV services in Nairobi from 10th Dec 2003. Patients who declined the HIV test were allowed to "opt out" and assured of uncompromised TB care. Those who accepted were tested for HIV in the laboratory next door using two parallel rapid HIV tests (Determine and Unigold). Concordance of the two tests defined HIV test outcome within 20 minutes. Lessons learned: Over 3 weeks, DCT was offered to 33 TB patients; 20 (61%) accepted HIV testing while 13 declined. Half of those tested were HIV+ Implementation of the DCT concept is in active progress at this facility and replaces an earlier procedure where only 40% of some 1,500 TB patients referred for VCT accepted HIV testing. Besides improved care and prevention of HIV transmission, DCT seems a promising answer to stigma and long waiting time cited as reasons for the low VCT acceptance rate. Increased DCT uptake should occur if supported by appropriate policy guidelines and combined patient/care provider education. Recommendations: Nationwide implementation of the DCT concept targeting some 120,000 TB patients expected to be registered in Kenya over 2004. TB services offering DCT are potential sites for recruiting patients for ARVs.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adult
- Africa South of the Sahara
- Counseling
- HIV
- HIV Infections
- HIV Seropositivity
- HIV Seroprevalence
- Humans
- Kenya
- Research Design
- Tuberculosis, Pulmonary
- diagnosis
- psychology
Other ID:
UI: 102279529
From Meeting Abstracts