Patient acceptance of HIV testing services in rural emergency departments in South Africa
- Aditi Rao, Caitlin Kennedy, Pamela Mda, Thomas C. Quinn, David Stead, Bhakti Hansoti
- Authors: Aditi Rao , Caitlin Kennedy , Pamela Mda , Thomas C. Quinn , David Stead , Bhakti Hansoti
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3270 , vital:43287 , https://doi.org/10.4102/sajhivmed.v21i1.1105
- 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. Keywords: HIV counselling and testing; South Africa; emergency department; patient acceptance; implementation research; linkage to care.
- Full Text:
- Date Issued: 2020
- Authors: Aditi Rao , Caitlin Kennedy , Pamela Mda , Thomas C. Quinn , David Stead , Bhakti Hansoti
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3270 , vital:43287 , https://doi.org/10.4102/sajhivmed.v21i1.1105
- 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. Keywords: HIV counselling and testing; South Africa; emergency department; patient acceptance; implementation research; linkage to care.
- Full Text:
- Date Issued: 2020
Patient and provider attitudes to emergency department-based HIV counselling and testing in South Africa
- Authors: Bhakti Hansoti
- Date: 2017
- Language: English
- Type: Journal
- Identifier: http://hdl.handle.net/11260/5705 , vital:44634
- Full Text:
- Authors: Bhakti Hansoti
- Date: 2017
- Language: English
- Type: Journal
- Identifier: http://hdl.handle.net/11260/5705 , vital:44634
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