Counseling and testing TB patients for HIV: evaluation of three implementation models in Kinshasa, Congo

• Published in: The international journal of tuberculosis and lung disease Vol. 12; no. 3; pp. S73 - S78
• Main Authors: Van Rie, A, Sabue, M, Jarrett, N, Westreich, D, Behets, F, Kokolomani, J, Bahati, E R
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01-03-2008
• Subjects: Adolescent; Adult; Age Factors; AIDS Serodiagnosis; Ambulatory Care - organization & administration; Anti-Infective Agents - therapeutic use; Child; Child, Preschool; Collaborative Activities; Democratic Republic Of Congo; Democratic Republic of the Congo - epidemiology; Directive Counseling - organization & administration; Female; HIV; HIV Infections - complications; HIV Infections - diagnosis; HIV Infections - therapy; Human immunodeficiency virus; Humans; Infant; Male; Mycobacterium; Prevalence; Recurrence; Referral and Consultation; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Tuberculosis - complications; Tuberculosis - therapy; Voluntary Programs - organization & administration; Democratic Republic of the Congo
• ISSN: 1027-3719

SETTING: Kinshasa, Democratic Republic of Congo.OBJECTIVES: To evaluate the implementation of three models of provider-initiated HIV counseling and testing (CT) for tuberculosis (TB) patients.METHODS: HIV CT was offered to all TB patients aged ≥18 months registered for treatment
at three project clinics between August 2004 and June 2005. HIV CT was performed at the TB clinic, the health center or the freestanding voluntary counseling and testing (VCT) center. HIV-infected patients received cotrimoxazole prophylaxis.RESULTS: Uptake of HIV CT was high (95-98%)
when performed at the TB clinic or primary health care center, but significantly lower (68.5%) among patients referred to a free-standing VCT center. The overall HIV prevalence among the 1088 patients tested for HIV was 18.8%. HIV was associated with female sex (aOR 1.91), recurrent TB (aOR
2.74), extra-pulmonary TB (aOR 1.97) and age.CONCLUSIONS: Implementation of provider-initiated routine HIV CT by the TB nurse or health care worker at the primary health care center results in a higher uptake compared to referral of patients with TB to freestanding VCT clinics. Provider-initiated
HIV CT is only a first step and needs to be linked to access to HIV care, support and treatment.