Uptake of provider-initiated HIV testing and counseling among women attending an urban sexually transmitted disease clinic in South Africa – missed opportunities for early diagnosis of HIV infection

Abstract This study assessed the uptake of provider-initiated HIV testing and counseling (PITC) among women attending an urban sexually transmitted diseases (STD) clinic in South Africa. From July 2005 to June 2006, women were offered HIV testing following group information and education on HIV and STDs in the clinic waiting area. Of those who were provided with education, information, and offered HIV testing, uptake was 43.5% (2439/5612). The overall HIV prevalence among those tested was 56.5% and the prevalence of acute HIV infection was 1.2%. Of the 56.5% (3173/5612) refusing to test, the reasons for not testing were having already been tested for HIV (61.8%), being afraid to test or felt unready to test (32.5%), the need to consult with partner (0.9%), and refusing with no explanation (4.8%). In settings where high-risk patients await health care services, such as an STD clinic, failure to implement PITC is a missed opportunity for patients to benefit from counseling, prevention, early diagnosis, and referral into care and treatment for HIV infection.

[1]  N. Rollins,et al.  Rapid Testing May Not Improve Uptake of HIV Testing and Same Day Results in a Rural South African Community: A Cohort Study of 12,000 Women , 2008, PloS one.

[2]  S. A. Abdool Karim,et al.  The influence of AIDS stigma and discrimination and social cohesion on HIV testing and willingness to disclose HIV in rural KwaZulu-Natal, South Africa , 2008 .

[3]  S. Gruskin,et al.  Provider-initiated HIV testing and counseling in health facilities--what does this mean for the health and human rights of pregnant women? , 2008, Developing world bioethics.

[4]  N. Sewankambo,et al.  Acceptability of routine HIV counselling and testing, and HIV seroprevalence in Ugandan hospitals. , 2008, Bulletin of the World Health Organization.

[5]  T. Bärnighausen,et al.  High HIV incidence in a community with high HIV prevalence in rural South Africa: findings from a prospective population-based study , 2008, AIDS.

[6]  Y. Maldonado,et al.  Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe. , 2007, Bulletin of the World Health Organization.

[7]  R. Walensky,et al.  Routine Voluntary HIV Testing in Durban, South Africa: The Experience From an Outpatient Department , 2007, Journal of acquired immune deficiency syndromes.

[8]  N. Shaffer,et al.  Successful Introduction of Routine Opt-Out HIV Testing in Antenatal Care in Botswana , 2007, Journal of acquired immune deficiency syndromes.

[9]  S. Karim,et al.  Utilizing nucleic acid amplification to identify acute HIV infection. , 2007, AIDS.

[10]  A. Puren,et al.  National HIV incidence measures--new insights into the South African epidemic. , 2007, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[11]  Guidance ON PROVIDER-INITIATED.  Comments on the draft document “Guidance on Provider-initiated HIV Testing and Counselling in Health Facilities” , 2007 .

[12]  I. Kleinschmidt,et al.  Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey , 2005, AIDS.

[13]  William C Miller,et al.  Detection of acute infections during HIV testing in North Carolina. , 2005, The New England journal of medicine.

[14]  P. Moodley,et al.  Association Between HIV-1 Infection, the Etiology of Genital Ulcer Disease, and Response to Syndromic Management , 2003, Sexually transmitted diseases.

[15]  G. Garnett,et al.  A Systematic Review of the Epidemiologic Interactions Between Classic Sexually Transmitted Diseases and HIV: How Much Really Is Known? , 2001, Sexually transmitted diseases.

[16]  S. Karim,et al.  Estimating HIV incidence rates from age prevalence data in epidemic situations , 2001, Statistics in medicine.

[17]  E. Gouws,et al.  High HIV Incidence and Prevalence Among Young Women in Rural South Africa: Developing a Cohort for Intervention Trials , 2000, Journal of Acquired Immune Deficiency Syndromes.

[18]  H. Coovadia,et al.  Informed consent for HIV testing in a South African hospital: is it truly informed and truly voluntary? , 1998, American journal of public health.