Implementation and Operational Research: Implementation of Routine Counselor-Initiated Opt-Out HIV Testing on the Adult Medical Ward at Kamuzu Central Hospital, Lilongwe, Malawi. (1st May 2015)

• Record Type: Journal Article
• Authors: LaCourse, Sylvia M.; Chester, Frances M.; Matoga, Mitch; Munthali, Charles; Nsona, Dominic; Haac, Bryce; Hoffman, Irving F.; Hosseinipour, Mina C.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 69(2015)Supplement 1
• Publication Date: 2015-05-01
• Subjects: provider-initiated HIV testing and counseling (PITC) -- task shifting -- lay-counselor -- HIV prevalence -- HIV case finding; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000000542
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Abstract: The optimal approach of provider-initiated HIV testing and counseling (PITC) for inpatients in high-burden settings is unknown. We prospectively evaluated the implementation of task shifting from clinician-referral to counselor-initiated PITC on the medical wards of Kamuzu Central Hospital, Malawi. Most of patients (1905/3154, 60.4%) had an unknown admission HIV status. Counselors offered testing to 66.6% (1268/1905). HIV prevalence was 39.3%. Counselor-initiated PITC significantly increased HIV testing by 79% (643/2957 vs. 1228/3154), resulting in an almost 2-fold increase in patients with known HIV status (2447/3154 vs. 1249/3154) (both P < 0.0001), with 18.4% of those tested receiving a new diagnosis of HIV. Abstract : Supplemental Digital Content is Available in the Text.