Household HIV Testing Uptake among Contacts of TB Patients in South Africa
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...
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| Published in | PloS one Vol. 11; no. 5; p. e0155688 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Public Library of Science
19.05.2016
Public Library of Science (PLoS) |
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| Abstract | 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. |
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| AbstractList | 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.BACKGROUNDIn 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.METHODSWe 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.RESULTS & DISCUSSIONOut 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.CONCLUSIONHCT 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. Background 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. Methods 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. Results & Discussion 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. Conclusion 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. Background 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. Methods 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 [greater than or equal to]14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model. Results & Discussion Out of 1,887 listed household members [greater than or equal to]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. Conclusion 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. Background 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. Methods 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. Results & Discussion 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. Conclusion 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. BackgroundIn 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.MethodsWe 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.Results & discussionOut 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.ConclusionHCT 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. 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 [greater than or equal to]14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model. Out of 1,887 listed household members [greater than or equal to]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. 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. |
| Audience | Academic |
| Author | Charalambous, Salome Lewis, James J. Churchyard, Gavin J. Page-Shipp, Liesl Hoffmann, Christopher J. Velen, Kavindhran Popane, Flora |
| AuthorAffiliation | 1 The Aurum Institute, Johannesburg, South Africa 2 The School of Public Health, University of Witwatersrand, Johannesburg, South Africa 5 Johns Hopkins University School of Medicine, Baltimore, United States of America University of Malaya, MALAYSIA 4 Advancing Care and Treatment for TB and HIV, MRC Collaborating Centre of Excellence, Johannesburg, South Africa 3 London School of Hygiene and Tropical Medicine, London, United Kingdom |
| AuthorAffiliation_xml | – name: 5 Johns Hopkins University School of Medicine, Baltimore, United States of America – name: 4 Advancing Care and Treatment for TB and HIV, MRC Collaborating Centre of Excellence, Johannesburg, South Africa – name: 1 The Aurum Institute, Johannesburg, South Africa – name: 2 The School of Public Health, University of Witwatersrand, Johannesburg, South Africa – name: University of Malaya, MALAYSIA – name: 3 London School of Hygiene and Tropical Medicine, London, United Kingdom |
| Author_xml | – sequence: 1 givenname: Kavindhran surname: Velen fullname: Velen, Kavindhran – sequence: 2 givenname: James J. surname: Lewis fullname: Lewis, James J. – sequence: 3 givenname: Salome surname: Charalambous fullname: Charalambous, Salome – sequence: 4 givenname: Liesl surname: Page-Shipp fullname: Page-Shipp, Liesl – sequence: 5 givenname: Flora surname: Popane fullname: Popane, Flora – sequence: 6 givenname: Gavin J. surname: Churchyard fullname: Churchyard, Gavin J. – sequence: 7 givenname: Christopher J. surname: Hoffmann fullname: Hoffmann, Christopher J. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27195957$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1371_journal_pone_0200737 crossref_primary_10_1002_jia2_25014 crossref_primary_10_1186_s12889_019_6497_7 crossref_primary_10_1371_journal_pgph_0002609 crossref_primary_10_1111_tmi_12888 crossref_primary_10_1177_09564624221111277 crossref_primary_10_1016_j_jctube_2019_100130 crossref_primary_10_1371_journal_pone_0192089 crossref_primary_10_1136_bmjopen_2022_061508 |
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| Copyright | COPYRIGHT 2016 Public Library of Science 2016 Velen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2016 Velen et al 2016 Velen et al |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: SC LP-S GJC CJH. Performed the experiments: KV LP-S FP. Analyzed the data: KV JJL CJH. Wrote the paper: KV JJL SC LP-S FP GJC CJH. |
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| References | E Tumwesigye (ref13) 2010; 24 ref12 AE Shapiro (ref7) 2012; 185 P MacPherson (ref24) 2014; 312 T Mabuto (ref4) 2014; 9 O Shisana (ref3) 2014 ref10 (ref6) 2012 S Mitchell (ref16) 2010; 10 IV Bassett (ref20) 2014; 15 RV Barnabas (ref21) 2014; 1 JN Sekandi (ref14) 2011; 11 LA Parker (ref19) 2015 N Massyn (ref2) 2014 D Govindasamy (ref22) 2012; 26 H Tumwebaze (ref15) 2012; 7 E Lugada (ref5) 2010; 55 F Nuwaha (ref17) 2002; 79 JK Matovu (ref8) 2007; 12 D Govindasamy (ref23) 2014; 17 J Wachira (ref9) 2012; 54 (ref11) 2011 (ref1) 2014 ND Labhardt (ref18) 2014; 11 |
| References_xml | – volume: 7 start-page: e51620 issue: 12 year: 2012 ident: ref15 article-title: Household-based HIV counseling and testing as a platform for referral to HIV care and medical male circumcision in Uganda: a pilot evaluation publication-title: PloS one doi: 10.1371/journal.pone.0051620 – volume: 11 start-page: 730 year: 2011 ident: ref14 article-title: High acceptance of home-based HIV counseling and testing in an urban community setting in Uganda publication-title: BMC public health doi: 10.1186/1471-2458-11-730 – volume: 54 start-page: 275 issue: 2 year: 2012 ident: ref9 article-title: What is the impact of home-based HIV counseling and testing on the clinical status of newly enrolled adults in a large HIV care program in Western Kenya? publication-title: Clinical infectious diseases: an official publication of the Infectious Diseases Society of America doi: 10.1093/cid/cir789 – year: 2012 ident: ref6 article-title: Service delivery approaches to HIV testing and counselling (HTC): A strategic HTC programme framework – volume: 26 start-page: 2059 issue: 16 year: 2012 ident: ref22 article-title: Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review publication-title: AIDS doi: 10.1097/QAD.0b013e3283578b9b – year: 2014 ident: ref2 article-title: The District Health Barometer 2013/2014 – volume: 312 start-page: 372 issue: 4 year: 2014 ident: ref24 article-title: Effect of optional home initiation of HIV care following HIV self-testing on antiretroviral therapy initiation among adults in Malawi: a randomized clinical trial publication-title: JAMA doi: 10.1001/jama.2014.6493 – volume: 9 start-page: e102267 issue: 7 year: 2014 ident: ref4 article-title: Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa publication-title: PloS one doi: 10.1371/journal.pone.0102267 – volume: 10 start-page: 23 year: 2010 ident: ref16 article-title: Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries publication-title: BMC international health and human rights doi: 10.1186/1472-698X-10-23 – volume: 15 start-page: 367 issue: 6 year: 2014 ident: ref20 article-title: Linkage to care following community-based mobile HIV testing compared with clinic-based testing in Umlazi Township, Durban, South Africa publication-title: HIV Med doi: 10.1111/hiv.12115 – year: 2014 ident: ref1 article-title: 90-90-90 An ambitious treatment target to help end the AIDS epidemic – volume: 24 start-page: 735 issue: 11 year: 2010 ident: ref13 article-title: High uptake of home-based, district-wide, HIV counseling and testing in Uganda publication-title: AIDS patient care and STDs doi: 10.1089/apc.2010.0096 – year: 2015 ident: ref19 article-title: Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland publication-title: Tropical medicine & international health: TM & IH – volume: 79 start-page: 626 issue: 12 year: 2002 ident: ref17 article-title: Factors influencing acceptability of voluntary counselling and testing for HIV in Bushenyi district of Uganda publication-title: East African medical journal doi: 10.4314/eamj.v79i12.8669 – volume: 55 start-page: 245 issue: 2 year: 2010 ident: ref5 article-title: Comparison of home and clinic-based HIV testing among household members of persons taking antiretroviral therapy in Uganda: results from a randomized trial publication-title: Journal of acquired immune deficiency syndromes (1999) doi: 10.1097/QAI.0b013e3181e9e069 – volume: 11 start-page: e1001768 issue: 12 year: 2014 ident: ref18 article-title: Home-Based Versus Mobile Clinic HIV Testing and Counseling in Rural Lesotho: A Cluster-Randomized Trial publication-title: PLoS medicine doi: 10.1371/journal.pmed.1001768 – volume: 185 start-page: 1110 issue: 10 year: 2012 ident: ref7 article-title: Community-based targeted case finding for tuberculosis and HIV in household contacts of patients with tuberculosis in South Africa publication-title: American journal of respiratory and critical care medicine doi: 10.1164/rccm.201111-1941OC – year: 2014 ident: ref3 article-title: South African National HIV Prevalence, Incidence and Behaviour Survey, 2012 – volume: 12 start-page: 1315 issue: 11 year: 2007 ident: ref8 article-title: Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001–2007 publication-title: Tropical medicine & international health: TM & IH doi: 10.1111/j.1365-3156.2007.01923.x – volume: 17 start-page: 19032 year: 2014 ident: ref23 article-title: Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings—a systematic review publication-title: J Int AIDS Soc doi: 10.7448/IAS.17.1.19032 – year: 2011 ident: ref11 article-title: Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings – volume: 1 start-page: e68 issue: 2 year: 2014 ident: ref21 article-title: Initiation of antiretroviral therapy and viral suppression after home HIV testing and counselling in KwaZulu-Natal, South Africa, and Mbarara district, Uganda: a prospective, observational intervention study publication-title: Lancet HIV doi: 10.1016/S2352-3018(14)70024-4 – ident: ref10 – ident: ref12 |
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| Snippet | 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... Background In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB) patients. We evaluated... BackgroundIn high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB) patients. We evaluated... Background In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB) patients. We evaluated... |
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| Title | Household HIV Testing Uptake among Contacts of TB Patients in South Africa |
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