Screening for HIV among Patients at Tuberculosis Clinics – Results from Population-Based HIV Impact Assessment Surveys, Malawi, Zambia, and Zimbabwe, 2015-2016

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Citation

Kothegal, Nikhil; Wang, Alice; Jonnalagadda, Sasi; MacNeil, Adam; Radin, Elizabeth; Brown, Kristin; Mugurungi, Owen; Choto, Regis; Balachandra, Shirish; & Rogers, John H., et al. (2021). Screening for HIV among Patients at Tuberculosis Clinics - Results from Population-Based HIV Impact Assessment Surveys, Malawi, Zambia, and Zimbabwe, 2015-2016. Morbidity & Mortality Weekly Report, 70(10), 342-345. PMCID: PMC7951815

Abstract

The World Health Organization and national guidelines recommend HIV testing and counseling at tuberculosis (TB) clinics for all patients, regardless of TB diagnosis (1). Population-based HIV Impact Assessment (PHIA) survey data for 2015-2016 in Malawi, Zambia, and Zimbabwe were analyzed to assess HIV screening at TB clinics among persons who had positive HIV test results in the survey. The analysis was stratified by history of TB diagnosis* (presumptive versus confirmed†), awareness§ of HIV-positive status, antiretroviral therapy (ART) status, and viral load suppression among HIV-positive adults, by history of TB clinic visit. The percentage of adults who reported having ever visited a TB clinic ranged from 4.7% to 9.7%. Among all TB clinic attendees, the percentage who reported that they had received HIV testing during a TB clinic visit ranged from 48.0% to 62.1% across the three countries. Among adults who received a positive HIV test result during PHIA and who did not receive a test for HIV at a previous TB clinic visit, 29.4% (Malawi), 21.9% (Zambia), and 16.2% (Zimbabwe) reported that they did not know their HIV status at the time of the TB clinic visit. These findings represent missed opportunities for HIV screening and linkage to HIV care. In all three countries, viral load suppression rates were significantly higher among those who reported ever visiting a TB clinic than among those who had not (p<0.001). National programs could strengthen HIV screening at TB clinics and leverage them as entry points into the HIV diagnosis and treatment cascade (i.e., testing, initiation of treatment, and viral load suppression).

URL

http://dx.doi.org/10.15585/mmwr.mm7010a2

Reference Type

Journal Article

Year Published

2021

Journal Title

Morbidity & Mortality Weekly Report

Author(s)

Kothegal, Nikhil
Wang, Alice
Jonnalagadda, Sasi
MacNeil, Adam
Radin, Elizabeth
Brown, Kristin
Mugurungi, Owen
Choto, Regis
Balachandra, Shirish
Rogers, John H.
Musuka, Godfrey
Kalua, Thokozani
Odo, Michael
Auld, Andrew
Gunde, Laurence
Kim, Evelyn
Payne, Danielle
Lungu, Patrick
Mulenga, Lloyd
Hassani, Ahmed S.
Nkumbula, Tepa
Patel, Hetal
Parekh, Bharat
Voetsch, Andrew C.

Article Type

Regular

PMCID

PMC7951815

Data Set/Study

Population-Based HIV Impact Assessment (PHIA) Survey

Continent/Country

Malawi
Zimbabwe
Zambia

ORCiD

Kothegal - 0000-0002-3506-8377