Provider-initiated diagnostic HIV counselling and testing in tuberculosis clinics in Thailand

• Published in: The international journal of tuberculosis and lung disease Vol. 12; no. 8; pp. 955 - 961
• Main Authors: NATENIYOM, S, JITTIMANEE, S. X, VIRIYAKITJAR, D, JITTIMANEE, S, KEOPHAITHOOL, S, VARMA, J. K
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.08.2008; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents - therapeutic use; Biological and medical sciences; Care; Counseling; Female; HIV; HIV counselling; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV testing; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; Mycobacterium; Outpatient Clinics, Hospital; Patient Acceptance of Health Care; Pneumology; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Thailand; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Tuberculosis; Tuberculosis - complications; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Thailand; Asia; Human; Immunopathology; Retroviridae; AIDS; HIV counselling; Serology; Mycobacterial infection; Medical screening; Immune deficiency; Lentivirus; Council; Care; Infection; Virus; Tuberculosis; HIV; Viral disease; Bacteriosis; HIV testing; Tropical medicine; Diagnosis; Human immunodeficiency virus; Pneumology
• ISSN: 1027-3719; 1815-7920

SETTINGS: Twelve large public hospitals geographically distributed in Thailand.OBJECTIVES: To assess the uptake of diagnostic human immunodeficiency virus (HIV) counselling and testing (DCT), HIV prevalence in tuberculosis (TB) patients and HIV services provided to newly diagnosed HIV-infected TB patients.METHOD: We provided DCT in TB clinics to newly registered TB patients. Post-test counselling was provided at TB clinics for non-HIV-infected patients and at HIV voluntary counselling and testing centres for HIV-infected patients. HIV-infected patients were referred for HIV-related care during TB treatment.RESULTS: From July to October 2006, 8% of 1086 new TB patients were known to be HIV-infected at the time of TB diagnosis. Of 1000 patients with unknown HIV status, 93% were tested: HIV infection was diagnosed in 11%. Including patients with previously diagnosed HIV infection, 17% of all TB patients were HIV-infected. Of 99 newly diagnosed HIV patients, 36% received cotrimoxazole prophylaxis. Of 41 with CD4 < 200 cells/μl, 42% began antiretroviral treatment during TB treatment.CONCLUSION: The acceptance of DCT was high, but the provision of HIV services was disappointingly low. Increased staff capacity building, stronger coordination with the acquired immune-deficiency syndrome programme and better field supervision are needed to achieve universal access to care for HIV-infected TB patients.