BACKGROUND: Many individuals at risk for HIV may be reached through active TB case finding interventions in areas with highly prevalent co-epidemics of TB/HIV. METHODS: We analyzed data from a cluster-randomized trial of 2 TB case finding strategies: facility-based screening and contact investigation of newly identified TB cases. In both arms, on-site rapid HIV testing was offered to all contacts older than 18 months who did not self-report HIV-positive status. Those who were HIV infected were referred appropriately. All contacts 15 years and older were included in this analysis. RESULTS: Among 2179 contacts identified, 50% (1092) accepted HIV testing and counselling, of whom 6.3% (68) tested HIV-positive. Contacts who were unemployed [adjusted prevalence ratio (aPR) 1.14, 95% confidence interval (CI): 1.04 to 1.25], had not been to a clinic (aPR 1.09, 95% CI: 1.02 to 1.18) or HIV tested (aPR 1.25, 95% CI: 1.14 to 1.39) 6 months before, and those reporting gastrointestinal symptoms (aPR 1.22, 95% CI: 0.98 to 1.52) and genitourinary symptoms (aPR 1.30, 95% CI: 1.17 to 1.45) were significantly associated with accepting HIV testing. Women [adjusted odds ratio (aOR) 2.19, 95% CI: 1.26 to 3.81], individuals with a past history of tuberculosis (aOR 1.96, 95% CI: 0.93 to 4.14), and those not HIV tested 6 months before (aOR 2.20, 95% CI: 1.28 to 3.79) were significantly associated with testing HIV-positive. CONCLUSION: Offering HIV testing in the context of active tuberculosis case finding represents an opportunity to identify a large proportion of previously undiagnosed individuals with HIV in a population that might otherwise not seek testing.
BACKGROUND: Many individuals at risk for HIV may be reached through active TB case finding interventions in areas with highly prevalent co-epidemics of TB/HIV. METHODS: We analyzed data from a cluster-randomized trial of 2 TB case finding strategies: facility-based screening and contact investigation of newly identified TB cases. In both arms, on-site rapid HIV testing was offered to all contacts older than 18 months who did not self-report HIV-positive status. Those who were HIV infected were referred appropriately. All contacts 15 years and older were included in this analysis. RESULTS: Among 2179 contacts identified, 50% (1092) accepted HIV testing and counselling, of whom 6.3% (68) tested HIV-positive. Contacts who were unemployed [adjusted prevalence ratio (aPR) 1.14, 95% confidence interval (CI): 1.04 to 1.25], had not been to a clinic (aPR 1.09, 95% CI: 1.02 to 1.18) or HIV tested (aPR 1.25, 95% CI: 1.14 to 1.39) 6 months before, and those reporting gastrointestinal symptoms (aPR 1.22, 95% CI: 0.98 to 1.52) and genitourinary symptoms (aPR 1.30, 95% CI: 1.17 to 1.45) were significantly associated with accepting HIV testing. Women [adjusted odds ratio (aOR) 2.19, 95% CI: 1.26 to 3.81], individuals with a past history of tuberculosis (aOR 1.96, 95% CI: 0.93 to 4.14), and those not HIV tested 6 months before (aOR 2.20, 95% CI: 1.28 to 3.79) were significantly associated with testing HIV-positive. CONCLUSION: Offering HIV testing in the context of active tuberculosis case finding represents an opportunity to identify a large proportion of previously undiagnosed individuals with HIV in a population that might otherwise not seek testing.
Authors: Adrienne E Shapiro; Ebrahim Variava; Modiehi H Rakgokong; Neshen Moodley; Binnu Luke; Saeed Salimi; Richard E Chaisson; Jonathan E Golub; Neil A Martinson Journal: Am J Respir Crit Care Med Date: 2012-03-15 Impact factor: 21.405
Authors: Helen Ayles; Monde Muyoyeta; Elizabeth Du Toit; Ab Schaap; Sian Floyd; Musonda Simwinga; Kwame Shanaube; Nathaniel Chishinga; Virginia Bond; Rory Dunbar; Petra De Haas; Anelet James; Nico C Gey van Pittius; Mareli Claassens; Katherine Fielding; Justin Fenty; Charalampos Sismanidis; Richard J Hayes; Nulda Beyers; Peter Godfrey-Faussett Journal: Lancet Date: 2013-08-01 Impact factor: 79.321
Authors: Colleen F Hanrahan; Bareng A S Nonyane; Lesego Mmolawa; Nora S West; Tsundzukani Siwelana; Limakatso Lebina; Neil Martinson; David W Dowdy Journal: PLoS Med Date: 2019-04-30 Impact factor: 11.069
Authors: Elizabeth L Corbett; Tsitsi Bandason; Trinh Duong; Ethel Dauya; Beauty Makamure; Gavin J Churchyard; Brian G Williams; Shungu S Munyati; Anthony E Butterworth; Peter R Mason; Stanley Mungofa; Richard J Hayes Journal: Lancet Date: 2010-10-09 Impact factor: 79.321