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Free Content Low adherence to guidelines for preventing TB among persons with newly diagnosed HIV infection, United States

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SETTING: Persons infected with human immunodeficiency virus (HIV) are at risk for developing tuberculosis (TB) if latent TB infection remains untreated.

OBJECTIVE: To assess missed opportunities for preventing TB by selecting a population-based sample of 1093 persons diagnosed with HIV from June 1995 to June 1997 in Seattle, WA, New Orleans, LA, and Jersey City, NJ.

DESIGN: To determine the proportion of persons receiving a tuberculin skin test (TST) following HIV diagnosis, we conducted record reviews at providers and local TB control.

RESULTS: An estimated 53.7% (95%CI 49.9–57.4) had a TST following HIV diagnosis; 6.6% (95%CI 4.3–8.9%) of TST-tested patients were reactive. Median time between HIV diagnosis and TST was 1 month (mean 5.7 months, 95%CI 4.8–6.5). Factors associated with TST included additional risk factors for TB (OR 1.76, 95%CI 1.17–2.63), history of HIV-related preventive treatment (OR 5.84, 95%CI 3.74–8.75), higher number of clinic visits (OR 4.16, 95%CI 2.01–8.02), and attendance at facilities with a written policy to provide TST for all persons with HIV (OR 2.54, 95%CI 1.28–4.88).

CONCLUSION: About half of persons newly diagnosed with HIV infection had a TST following HIV diagnosis, with little variation by demographics, signaling a general need to improve interventions to prevent TB.

Keywords: HIV; TST; guidelines; prevention

Document Type: Regular Paper

Affiliations: 1: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: Public Health—Seattle & King County, Seattle, Washington, USA 4: Health Sciences Center, Louisiana State University, New Orleans, Louisiana, USA; and Louisiana Department of Health and Hospitals, New Orleans, Louisiana, USA 5: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and New Jersey Department of Health and Senior Services, Trenton, New Jersey, USA

Publication date: 2006-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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