Eligibility for HIV/AIDS treatment among adults in a medical emergency setting at an urban hospital in Uganda.

Abstract

Despite global effort to scale up access to antiretroviral therapy (ART), many people in need of HIV/AIDS care in Uganda have not been reached. HIV testing and ART are not widely offered as routine medical services and data on HIV/AIDS in emergency settings in Sub-Saharan Africa is limited. We determined the HIV prevalence and eligibility for ART in a medical emergency unit at Mulago hospital. In a cross-sectional study, we interviewed 223 patients who were systematically selected from the patients' register from October through December 2004. HIV testing was offered routinely and results were delivered within 30 minutes. We evaluated HIV infected patients for WHO clinical stage of disease and referred them for HIV/AIDS care. Out of 223 patients, 111 (50%) had HIV infection of whom 78 (70%) had WHO clinical stage 3 and 4 of disease thereby requiring ART. Overall, 84 out of 111 (76%) HIV positive patients had not received any specific HIV/AIDS care. The burden of HIV infection in the medical emergency unit is high and majority of the patients who required ART had no prior HIV/AIDS care. We recommend scale up of HIV/AIDS care in acute care settings in order to increase access to ART.