Free Content Association between distance to HIV testing site and uptake of HIV testing for tuberculosis patients in Cambodia

Authors: Kanara, N.1; Cain, K.P.2; Chhum, V.3; Eng, B.4; Kim, S.3; Keo, S.3; Heller, T.A.1; Varma, J.K.5

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 2, February 2009 , pp. 226-231(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: Banteay Meanchey Province, Cambodia.

OBJECTIVE: Cambodia has the highest incidence of tuberculosis (TB) in Asia. Not all TB patients are tested for human immunodeficiency virus (HIV). We assessed the association between distance to HIV testing facility and HIV testing rates.

METHODS: We analyzed data on TB patients from 11 clinics to determine the proportion tested for HIV infection. We categorized each TB clinic as having a voluntary confidential counseling and testing (VCCT) center onsite, or being at <15 min, 15-30 min or >30 min driving distance to the nearest VCCT.

RESULTS: Of 1017 TB patients not previously tested for HIV, 708 (70%) were tested. Of 481 TB patients without onsite VCCT, 297 (62%) were tested, compared to 410 (77%) of 535 TB patients with onsite VCCT (RR 0.6, 95%CI 0.5-0.7). When the VCCT site was >15 min from the TB clinic, HIV testing occurred only half as frequently as when onsite VCCT was available.

CONCLUSION: TB patients treated at clinics without onsite or nearby HIV testing are less commonly tested for HIV infection. Making HIV testing available to TB patients without the necessity of traveling to a distant HIV testing site is likely to increase HIV testing rates.

Keywords: tuberculosis; Cambodia; epidemiology; HIV

Document Type: Regular paper

Affiliations: 1: United States Centers for Disease Control and Prevention Global AIDS Program-Cambodia, Phnom Penh, Cambodia 2: US Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: Banteay Meanchey Provincial Health Department, Sereysophon, Cambodia 4: United States Centers for Disease Control and Prevention Global AIDS Program-Cambodia, Phnom Penh, Cambodia; and Banteay Meanchey Provincial Health Department, Sereysophon, Cambodia 5: US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA; and Thailand Ministry of Public Health, US CDC Collaboration, Nonthaburi, Thailand

Publication date: 2009-02-01

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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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