Household HIV Testing Uptake among Contacts of TB Patients in South Africa

• Published in: PloS one Vol. 11; no. 5; p. e0155688
• Main Authors: Velen, Kavindhran, Lewis, James J., Charalambous, Salome, Page-Shipp, Liesl, Popane, Flora, Churchyard, Gavin J., Hoffmann, Christopher J.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.05.2016; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Antiretroviral drugs; Biology and Life Sciences; Care and treatment; CD4-Positive T-Lymphocytes - cytology; Cluster Analysis; Confidence intervals; Consent; Contact; Contact tracing; Contact Tracing - methods; Counseling; Diagnosis; Drug therapy; Ethics; Evaluation; Family Characteristics; Female; HIV; HIV infections; HIV Infections - complications; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV tests; Households; Human immunodeficiency virus; Human subjects; Humans; Hygiene; Infections; Isoniazid - therapeutic use; Male; Mass Screening; Medical diagnosis; Medical tests; Medicine; Medicine and Health Sciences; Middle Aged; Multivariate Analysis; Mycobacterium; Odds Ratio; Patients; People and places; Prevalence; Public Health; Regression Analysis; Regression models; Risk factors; South Africa - epidemiology; Statistical analysis; Systematic review; Tuberculosis; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - epidemiology; Ultrasonic testing; Young Adult; United States; United Kingdom > UK; South Africa; Uganda
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0155688

In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB) patients. We evaluated the uptake of HIV counselling and testing (HCT) among household contacts of index TB patients and the proportion of newly diagnosed HIV-infected persons linked into care as part of a household TB contact tracing study. We recruited index TB patients at public health clinics in two South African provinces to obtain consent for household contact tracing. During scheduled household visits we offered TB symptom screening to all household members and HCT to individuals ≥14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model. Out of 1,887 listed household members ≥14 years old, 984 (52%) were available during a household visit and offered HCT of which 108 (11%) self-reported being HIV infected and did not undergo HCT. Of the remaining 876, a total of 304 agreed to HCT (35%); 26 (8.6%) were newly diagnosed as HIV positive. In multivariable analysis, factors associated with uptake of HCT were prior testing (odds ratio 1.6; 95% confidence interval [CI]: 1.1-2.3) and another member in the household testing (odds ratio 2.4; 95% CI: 1.7-3.4). Within 3 months of testing HIV-positive, 35% reported initiating HIV care. HCT as a component of household TB contact tracing reached individuals without prior HIV testing, however uptake of HIV testing was poor. Strategies to improve HIV testing in household contacts should be evaluated.