Patient acceptance of HIV testing services in rural emergency departments in South Africa
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Patient acceptance of HIV testing services in rural emergency departments in South Africa | |
| Creator | Rao, Aditi Kennedy, Caitlin Mda, Pamela Quinn, Thomas C. Stead, David Hansoti, Bhakti | |
| Description | Background: South Africa faces the highest burden of HIV infection globally. The National Strategic Plan on HIV recommends provider-initiated HIV counselling and testing (HCT) in all healthcare facilities. However, HIV continues to overwhelm the healthcare system. Emergency department (ED)-based HCT could address unmet testing needs.Objectives: This study examines the reasons for accepting or declining HCT in South African EDs to inform the development of HCT implementation strategies.Method: We conducted a prospective observational study in two rural EDs, from June to September 2017. Patients presenting to the ED were systematically approached and offered a point-of-care test in accordance with national guidelines. Patients demographics, presenting compaint, medical history and reasons for accepting/declining testing, were recorded. A pooled analysis is presented.Results: Across sites, 2074 adult, non-critical patients in the ED were approached; 1880 were enrolled in the study. Of those enrolled, 19.7% had a previously known positive diagnosis, and 80.3% were unaware of their HIV status. Of those unaware, 90% patients accepted and 10% declined testing. The primary reasons for declining testing were ‘does not want to know status’ (37.6%), ‘in too much pain’ (34%) and ‘does not believe they are at risk’ (19.9%).Conclusions: Despite national guidelines, a high proportion of individuals remain undiagnosed, of which a majority are young men. Our study demonstrated high patient acceptance of ED-based HCT. There is a need for investment and innovation regarding effective pain management and confidential service delivery to address patient barriers. Findings support a routine, non-targeted HCT strategy in EDs. | |
| Publisher | AOSIS | |
| Date | 2020-07-22 | |
| Identifier | 10.4102/sajhivmed.v21i1.1105 | |
| Source | Southern African Journal of HIV Medicine; Vol 21, No 1 (2020); 9 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1105/1925
https://sajhivmed.org.za/index.php/hivmed/article/view/1105/1924
https://sajhivmed.org.za/index.php/hivmed/article/view/1105/1926
https://sajhivmed.org.za/index.php/hivmed/article/view/1105/1923
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