Elevated HIV seroprevalence and risk behavior among Ugandan TB suspects: implications for HIV testing and prevention
METHODS: Consenting adult patients presenting for evaluation at a referral TB clinic received same-day VCT. TB diagnosis data were abstracted from clinical records.
RESULTS: Among 665 eligible patients, 565 (85%) consented to VCT. Among these, 238 (42%) were HIV-positive. Of the HIV-infected patients, 37% had received a non-TB diagnosis. HIV seroprevalence was higher in patients with a non-TB diagnosis (49%) than those diagnosed with TB (39%) (P = 0.02). Fewer than 6% of HIV-infected patients reported always using condoms with sexual partners. The majority of patients (86%) reported being ‘very willing’ to refer family members for VCT.
CONCLUSIONS: Over 35% of HIV-infected cases in our population would have been undetected if HIV testing was limited to cases with diagnosed TB. The high HIV seroprevalence in both TB and non-TB cases merits HIV testing for all patients evaluated at TB clinics. HIV-infected TB suspects reporting high-risk behavior are at risk for HIV transmission, and should receive risk-reduction counseling.
Document Type: Regular Paper
Affiliations: 1: Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, California, USA; and Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA 2: Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, California, USA 3: National Tuberculosis and Leprosy Program, Mulago Hospital, Kampala, Uganda 4: Division of Infectious Diseases and Epidemiology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA 5: Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA
Publication date: 2007-02-01
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