Integrating HIV testing programmes into primary medical care can help achieve early diagnosis of HIV infection, even in relatively poor areas, research published in the online open access journal AIDS Research and Therapy has shown.
Researchers from Harvard Medical School and the non-governmental organisation Partners In Health (PIH, www.pih.org), both based in Boston, USA set out to see if HIV diagnosis was delayed because doctors missed opportunities to test people who were at risk of HIV during clinic visits.
The team works with the Haitian Ministry of Health to improve patients' access to primary care in central Haiti. This includes "provider-initiated HIV testing" (offering patients HIV tests when they visit primary care clinics) and the provision of free HIV treatment if required. The researchers then looked back at records from a single primary care clinic to examine the 'missed opportunities' and delays in diagnosing patients with HIV.
The researchers found few missed opportunities for diagnosis in the clinic - 85% of the first 112 patients found to have HIV were diagnosed on their first visit to the doctor. Patients with HIV who were not diagnosed on their first visit had to wait a median of just 62 days until diagnosis.
In the developing world, much HIV testing is done through maternity clinics or special HIV clinics that perform voluntary counselling and testing (i.e. on request of the individuals themselves) but that often do not provide other medical services or comprehensive HIV treatment. The authors suggest that provider-initiated testing at primary care clinics can be an effective way to identify patients with HIV infection.
They write: "HIV prevention and treatment programs will not achieve success without addressing the urgent need for individuals to be aware of their HIV status in a timely manner and provider-initiated testing can be a successful strategy to address this concern."
Provider-initiated HIV testing in rural Haiti: low rate of missed opportunities for diagnosis of HIV in a primary care clinic
Louise C Ivers, Kenneth A Freedberg and Joia S Mukherjee
AIDS Research and Therapy (in press)
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About AIDS Research and Therapy
AIDS Research and Therapy is an open access, online journal that publishes peer-reviewed research articles from scientists working to prevent the spread of AIDS. AIDS Research and Therapy aims to publish basic science as well as clinically important research articles that impact on abating the spread of AIDS. This multidisciplinary journal aims to keep scientists and clinicians abreast of the latest research on HIV-1. The ultimate goal of the journal's focus is to lead bench research to bedside practice to combat AIDS. AIDS is spreading at alarming rates in several African and Asian countries. Thus, any development that occurs in combating AIDS should be disseminated as rapidly as possible through the world. Although there are several AIDS-related journals in print, none of them are openly accessible to the world through the Internet. AIDS Research and Therapy will provide an open access journal specifically devoted to HIV-1 and AIDS research.
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