Implementation and Operational Research: Implementation of Routine Counselor-Initiated Opt-Out HIV Testing on the Adult Medical Ward at Kamuzu Central Hospital, Lilongwe, Malawi

J Acquir Immune Defic Syndr. 2015 May 1;69(1):e31-5. doi: 10.1097/QAI.0000000000000542.

Abstract

The optimal approach of provider-initiated HIV testing and counseling (PITC) for inpatients in high-burden settings is unknown. We prospectively evaluated the implementation of task shifting from clinician-referral to counselor-initiated PITC on the medical wards of Kamuzu Central Hospital, Malawi. Most of patients (1905/3154, 60.4%) had an unknown admission HIV status. Counselors offered testing to 66.6% (1268/1905). HIV prevalence was 39.3%. Counselor-initiated PITC significantly increased HIV testing by 79% (643/2957 vs. 1228/3154), resulting in an almost 2-fold increase in patients with known HIV status (2447/3154 vs. 1249/3154) (both P < 0.0001), with 18.4% of those tested receiving a new diagnosis of HIV.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Counseling*
  • Female
  • HIV Infections / diagnosis*
  • Health Services Research*
  • Hospitals
  • Humans
  • Malawi
  • Male
  • Middle Aged
  • Prospective Studies
  • Young Adult