HIV screening among patients seeking care at Xuanwu Hospital: A cross-sectional study in Beijing, China, 2011-2016.

Rui Li,Guoguang Zhao,Haiping Zhang,Chu Zhou,Zhigang Liang,Ya Zuo,Yan Zhao,Jennifer M Mcgoogan,Zunyou Wu,Jia Li,Lan Lan,Geng-Feng Fu

doi:10.1371/journal.pone.0208008

Abstract

ObjectivesOne-third of people living with HIV in China are still unaware of their status, so we sought to better understand HIV testing in the general hospital setting in China.MethodsA cross-sectional study was conducted using the electronic medical records of all patients who attended Xuanwu Hospital in Beijing, January 1, 2011 to December 31, 2016. HIV screening and detection rates and characteristics of patients diagnosed with HIV were assessed.ResultsOverall, 235,961 patients were screened, for a screening rate of 1.4%. Although most were outpatients (98.4%), screening rate was higher among inpatients (70.0% versus 0.4%), and highest in internal medicine (36.1%) and surgery (33.3%) departments. A total of 140 patients were diagnosed with HIV, for a detection rate of 5.93 per 10,000. Detection rates were highest among outpatients (9.34 per 10,000), and patients attending the dermatology and sexually transmitted infection (STI) department (153.85 per 10,000). Most diagnoses were made among males (91.4%), aged 20–39 (67.1%), who reported becoming infected through homosexual contact (70.0%).ConclusionsHIV screening in China’s general hospitals needs to be improved. More focus should be placed on screening outpatients, especially in the dermatology and STI department, and young men.

Highlights

HIV testing has been a cornerstone of China’s work toward control and prevention since the beginning of its HIV/AIDS epidemic response[1]
More focus should be placed on screening outpatients, especially in the dermatology and sexually transmitted infection (STI) department, and young men
HIV screening at Xuanwu Hospital the writing of the report; and in the decision to submit the article for publication

Summary

Introduction

HIV testing has been a cornerstone of China’s work toward control and prevention since the beginning of its HIV/AIDS epidemic response[1]. In 2002, fees for HIV voluntary counseling and testing (VCT) were eliminated, and by 2004, coverage had been expanded nationwide[2]. In 2004, Henan province became the first to embark on a large-scale testing program— public health workers went door-to-door in search of those who may have donated blood in the 1990s to offer them free HIV screening. This program yielded 23,157 new cases in just 3 months. In 2007, HIV provider-initiated testing and counseling (PITC) was introduced and has since expanded dramatically[2]. Over the subsequent 10 years, strong focus on testing has persisted—45 million HIV tests administered nationwide in 2008 rose to nearly 145 million in 2015, 72% of which resulted from PITC in medical settings[1]

Objectives

Results

Conclusion