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Non-Targeted HIV Testing in ER Acceptable to Patients

The program, in South Africa, identifies a high number of cases, including undiagnosed ones

THURSDAY, March 29, 2018 (HealthDay News) — A non-targeted HIV testing approach in a South African emergency department is acceptable to patients and reveals a high HIV prevalence, including undiagnosed cases, according to a study published online March 13 in PLOS ONE.

Bhakti Hansoti, M.B.Ch.B., from Johns Hopkins University in Baltimore, and colleagues quantified the burden of undiagnosed HIV infection in a South African emergency department based on findings following implementation of the National South African HIV testing guidelines (counselor initiated non-targeted universal screening with rapid point-of-care testing) for 24 hours a day at Frere Hospital in the Eastern Cape (Sept. 1 to Nov. 30, 2016).

The researchers found that 2,355 of the 9,583 patients (24.6 percent) who presented to the emergency department during the study period were approached by the HIV counseling and testing staff; 72.8 percent of patients accepted testing. Testing uptake was highest (78.6 percent) among a predominantly male (58 percent) patient group who mostly presented with traumatic injuries (70.8 percent). Just over one in five patients (21.6 percent) were HIV positive, including 6.2 percent with newly diagnosed HIV infection. The overall prevalence of HIV infection was twice as high in females compared to males (29.8 versus 15.4 percent); however, males and females had a similar prevalence of newly diagnosed HIV infection (6.0 percent for all females and 6.4 percent for all males).

“Unfortunately, a counselor-driven HIV testing approach fell short of meeting the testing needs in this setting, with over 75 percent of emergency department patients not approached by HIV counseling and testing staff,” the authors write.

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