Provider-Initiated HIV Testing and Counseling: Increased Uptake in Two Public Community Health Centers in South Africa and Implications for Scale-Up

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Dalal, Shona ; Lee, Chung-won ; Farirai, Thato ; Schilsky, Allison ; Goldman, Thurma ; Moore, Janet ; Bock, Naomi N.
• Description:
  Background
  
  International guidance recommends the scale up of routinely recommended, offered, and delivered health care provider-initiated HIV testing and counseling (PITC) to increase the proportion of persons who know their HIV status. We compared HIV test uptake under PITC to provider-referral to voluntary counseling and testing (VCT referral) in two primary health centers in South Africa.
  
  Methods
  
  Prior to introducing PITC, clinical providers were instructed to refer systematically selected study participants to VCT. After PITC and HIV rapid test training, providers were asked to recommend, offer and provide HIV testing to study participants during the clinical consultation. Participants were interviewed before and after their consultation to assess their HIV testing experiences.
  
  Results
  
  HIV test uptake increased under PITC (OR 2.85, 95% CI 1.71, 4.76), and more patients felt providers answered their questions on HIV (104/141 [74%] versus 73/118 [62%] for VCT referral; p 0.04). After three months, only 4/106 (3.8%) HIV-positive patients had registered for onsite HIV treatment. Providers found PITC useful, but tested very few patients (range 0–15).
  
  Conclusion
  
  PITC increased the uptake of HIV testing compared with referral to onsite VCT, and patients reported a positive response to PITC. However, providing universal PITC will require strong leadership to train and motivate providers, and interventions to link HIV-positive persons to HIV treatment centers.
  
  
• Subjects:
  Adolescent Adult AIDS Serodiagnosis Community Health Centers Counseling Female Health Personnel Health Policy HIV HIV Infections Humans Intervention Studies Male Mass Screening Middle Aged Young Adult

  More +
• Source:
  PLoS One. 2011; 6(11).
• Document Type:
  Journal Article
• Place as Subject:
  South Africa
• Volume:
  6
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:74cd0f15175287d24f29336651091b77915af48e5f0d1b31d10ac976e5f7ce0e
• Download URL:
  https://stacks.cdc.gov/view/cdc/4348/cdc_4348_DS1.pdf
• File Type:
  [PDF - 223.77 KB ]