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Free Content Barriers to human immunodeficiency virus testing of tuberculosis patients in Thailand, 2004–2007

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Abstract:

SETTING: Tuberculosis (TB) clinics in five provinces and one national referral hospital in Thailand.

OBJECTIVE: To identify risk factors for TB patients not receiving human immunodeficiency virus (HIV) pre-test counseling and testing in Thailand.

DESIGN: We collected data on TB patients treated at participating facilities from 2004 to 2007. Patients with known HIV status at the time of TB diagnosis were excluded from the analysis. We performed multivariate logistic regression to determine patient and facility characteristics associated with HIV counseling and testing.

RESULTS: Of 15 903 TB patients, HIV pre-test counseling was provided to 13 604 (86%). HIV testing was provided to 11 702 (86%) of those counseled. Of 6141 patients with unknown HIV status, 2323 (38%) were treated in facilities that provide HIV testing in TB clinics compared with 6412 (58%) of 11 003 non-HIV-infected and 3814 (62%) of 6121 HIV-infected patients (P < 0.05). In multivariate analysis, patients treated in facilities in which HIV testing of TB patients was performed somewhere other than the TB clinic were significantly less likely to undergo HIV pre-test counseling (adjusted OR 1.55, 95%CI 1.28–1.86).

CONCLUSION: In Thailand, providing HIV testing directly in TB clinics, rather than in other settings, may increase the proportion of TB patients with known HIV status.

Keywords: HIV/AIDS; Thailand; counseling; provider-initiated; testing; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Thailand Ministry of Public Health, US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand 2: Thailand Ministry of Public Health, Nonthaburi, Thailand 3: Emory School of Medicine, Atlanta, Georgia, USA 4: Office of Disease Prevention and Control 7, Ubon-ratchathani, Thailand 5: Chiang Rai Provincial Public Health Office, Chiang Rai, Thailand 6: Research Institute of Tuberculosis, Tokyo, Japan 7: Tak Provincial Public Health Office, Tak, Thailand 8: Bangkok Metropolitan Health Administration, Bangkok, Thailand 9: Phuket Provincial Public Health Office, Phuket, Thailand 10: Bamrasnaradura Institute, Nonthaburi, Thailand 11: Thailand Ministry of Public Health, US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; and US Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: August 1, 2010

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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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