HIV counseling, testing, and care of tuberculosis patients at chest clinics--Guyana, 2005-2006.

Tuberculosis (TB) is a leading cause of morbidity and mortality among persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). During 2004, Guyana had an estimated TB incidence rate of 140 per 100,000 population, the fourth highest rate in the Americas (after Haiti, Bolivia, and Peru); Guyana also had an estimated adult HIV prevalence of 2.5%, and 20% of TB patients were reported to be infected with HIV. In 2000, the Guyana Ministry of Health (MOH) began providing HIV counseling, testing, and referrals to HIV/AIDS programs at its six public chest clinics. At the end of 2005, chest clinics also began providing co-trimoxazole preventive therapy (CPT) to HIV-infected TB patients as a measure against common opportunistic infections. During February-June 2006, an international team assessed the extent to which MOH chest clinics in Guyana had implemented these interventions during July 2005-June 2006. This report summarizes the results of that assessment, which determined that, among 253 TB patients sampled, 174 (69%) initially did not know their HIV-infection status; 127 (73%) of those patients were offered HIV counseling and testing, and 115 (91%) accepted and were tested for HIV. Of the 115 who were tested, 11 (10%) were determined to be HIV infected; overall, 68 (35%) of the 194 patients whose HIV-infection status was known were HIV infected (i.e., 11 who were tested at the chest clinics plus 57 with preexisting knowledge of their HIV status). These results indicate both a high rate of HIV infection among TB patients in Guyana and the ability of chest clinics to provide HIV-related interventions in resource-limited settings.