Provider-initiated HIV testing and counseling among tuberculosis patients in a hospital in the Oromia region of Ethiopia

Abstract

Routine testing for human immunodeficiency virus (HIV) in settings with generalized HIV epidemics affords the benefit of diagnosing the infection early and thereby preventing morbidity, mortality and sustained transmission; early detection hastens the initiation of cotrimoxazole prophylaxis and anti-retroviral treatment (ART). Therefore, the objective of this study was to assess HIV counseling and testing among tuberculosis patients under routine care conditions in the Bishoftu hospital within the Oromia region of Ethiopia. A retrospective study was conducted from a tuberculosis (TB) registry, which included data from all adult patients who were diagnosed and treated at Bishoftu Hospital in Oromia from 2009 through 2011. The data were reviewed, coded and entered into the computer software, SPSS version 16.0, for analysis. We used a descriptive and multi-variable logistic regression model to predict HIV-positive status. Among the 682 patients recorded on the TB registry, the required variables for this study were completed for 681 adult tuberculosis patients. Out of all the TB patients for whom the variables were collected, 98% (669/681) were offered HIV counseling and testing, and nearly all of them (668/669) accepted and were tested for HIV. Among those patients who accepted for testing and were tested for HIV, 32.2% (215/668) tested positive. Pulmonary TB, among all types of all forms of TB, urban residence and the 25-64 age group were more generally associated with an HIV-positive status; however, male sex and pulmonary-positive types of TB were less likely to be HIV-positive. The acceptance rate for HIV counseling and testing services among TB patients was very high. However, there were missed cases in which the test was not offered. The prevalence of HIV was very high, and the infection was more prevalent among urban residents, females, young people and pulmonary-negative TB patients; thus, these patients need attention from all concerned parties.