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, MBChB, 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). 

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

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

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