- Title
- Patient acceptance of HIV testing services in rural emergency departments in South Africa
- Creator
- Aditi Rao
- Creator
- Caitlin Kennedy
- Creator
- Pamela Mda
- Creator
- Thomas C. Quinn
- Creator
- David Stead
- Creator
- Bhakti Hansoti
- Date Issued
- 2020
- Date
- 2020
- Type
- text
- Type
- article
- Identifier
- http://hdl.handle.net/11260/3270
- Identifier
- vital:43287
- Identifier
- 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.
- Format
- 9 pages
- Format
- Publisher
- AOSIS
- Language
- English
- Relation
- Southern African Journal of HIV Medicine
- Relation
- Rao A, Kennedy C, Mda P, Quinn TC, Stead D, Hansoti B. Patient acceptance of HIV testing services in rural emergency departments in South Africa. S Afr J HIV Med. 2020;21(1), a1105. https://doi.org/10.4102/sajhivmed.v21i1.1105
- Relation
- Southern African Journal of HIV Medicine volume 21 Issue 1 22 07 2020 (Online) 2078-6751 , (Print) 1608-9693
- Rights
- © 2020 AJHTL /Author/s
- Rights
- © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License
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