Expansion of HIV Laboratory Diagnostic Services in Chennai, India 2001–2006: Is the Growth Commensurate with the Need?

Aylur K Srikrishnan ,Suniti Solomon,Pachamuthu Balakrishnan,Kartik K Venkatesh,K G Kosalaraman,Kenneth H Mayer,Easter Thamburaj,Sam Anand

doi:10.1371/journal.pone.0003471

Aylur K Srikrishnan , Suniti Solomon + Show 6 more

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https://doi.org/10.1371/journal.pone.0003471

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Abstract

ObjectiveTo describe the changes in HIV services provided and the patient population utilizing voluntary counseling and testing (VCT) services at private testing laboratories in Chennai, India in 2001 and 2006.MethodsIn 2001, a cross-sectional descriptive survey was conducted to assess the services provided and client population of 1,031 private laboratories. A subset of labs (9%) that had been surveyed in 2001 were also studied in 2006.ResultsIn 2001, significantly more high volume labs (>10 HIV tests per month) offered HIV diagnostic tests than low volume labs (<10 HIV test per month) (p<0.001). More high volume labs (20.0%) provided pre-test counseling as part of HIV testing than low volume labs (11.1%) (p = 0.003). Between 2001 and 2006, the number of labs that provided HIV diagnostic tests significantly increased, including ELISA (87.8% vs. 40.0%), Western Blot (84.4% vs. 13.3%), and Tridot (98.9% vs. 72.2%) (p<0.001). Also the number of labs that reported greater than 10 women seeking HIV testing per month significantly increased from 14.5% to 79.0% (p = 0.006). More labs provided pre-test counseling in 2006 (34.4%) than in 2001 (21.1%) (p = 0.046).ConclusionsThough HIV diagnostic testing services have increasingly become available, counseling services have not expanded commensurately. Further outreach and education is necessary to expand comprehensive HIV VCT services in both urban and rural India.

Highlights

It is estimated that 2–3 million Indians are currently living with HIV and the overall HIV prevalence continues to rise [1]
For individuals found to be infected with HIV, voluntary counseling and testing (VCT) can provide a means to accessing further services, including counseling support, antiretroviral therapy (ART), and medical care
We describe the changes in services provided and the patient population utilizing VCT services at private testing laboratories in Chennai, India in 2001 and 2006

Summary

Introduction

It is estimated that 2–3 million Indians are currently living with HIV and the overall HIV prevalence continues to rise [1]. Tamil Nadu in South India is one of the six Indian states which has been classified as high prevalence, defined as having rates in excess of 5% among high risk groups and in excess of 1% of antenatal women [1,2]. Married monogamous women have presented with a high prevalence of HIV in India, suggesting a strong risk from their spouses [5]. Voluntary Counseling and Testing (VCT) is recognized as an integral element of any effective HIV public health primary prevention and care program [6]. HIV voluntary counseling and testing (VCT) has increasingly become a central prevention strategy in the national AIDS control policies of most developing countries as it serves as an important entry point into care [9]

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