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aidsmap Web Site Reports on URC’s Approach to Improving HIV Testing Among TB Patients

The web site aidsmap featured URC’s work to improve HIV/AIDS testing for TB patients in Lesotho among the successful approaches reported on at the HIV Implementers Conference held in Kampala, Uganda, June 3-7, 2008. The article entitled “Improving HIV diagnosis in TB patients: new approaches bearing fruit” dated July 24th, describes an approach being developed by URC’s project, Increasing Counseling and Testing and Enhancing HIV/AIDS Communications in Lesotho, South Africa and Swaziland, funded by the Centers for Disease Control and Prevention.

Research has shown that referring clients with TB to voluntary counseling and testing (VCT) facilities has resulted in low rates of testing for HIV, the article notes. As a result, a growing number of programs in PEPFAR-focus countries have introduced provider-initiated HIV testing and counseling (PITC) for TB patients. Last year, WHO endorsed PITC together with expanding VCT and released guidelines to assist countries to standardize and expand PITC through healthcare facilities. However, methods for providing PITC must be adapted to resources and support systems available in local settings.

At the HIV Implementers Conference in Kampala, URC’s Dr. Biggie Mabaera reported on project efforts to train lay counselors to provide PITC in six of Lesotho’s ten districts. He noted that when the project began in 2006, TB clinics referred people with TB to ART sites or voluntary counseling and testing centers (VCT) for HIV testing. This approach resulted in only about 16 percent of patients following through on referrals. 

URC began to train lay counselors in HIV testing and counseling (HTC), including TB symptoms, the relationship between TB and HIV, and how to record TB-HIV data. Results were rapid and dramatic, Dr. Mabaera reported. In 2007, 52 percent of registered TB cases were tested for HIV (78% of whom tested HIV-positive). By the first quarter of 2008, 74 percent of people with TB were being tested. One hospital, which had tested less than 1 percent of its TB patients in 2006, tested 75 percent of the TB patients in the first quarter of this year after the addition of just one lay counselor.

“Lay counselors—when they are properly supervised—can allow facilities to both rapidly expand HIV testing and counseling for TB patients and also implement integrated TB-HIV management. HIV testing and counseling uptake can also be improved by offering HTC services right in the TB clinics, rather than by referring patients to the ART clinic or to the VCT centers,” said Dr. Mabaera.

Link to the aidsmap article. For more information on URC’s work in Lesotho, Swaziland, and South Africa, please contact Ms. Katie Breese at kbreese@urc-chs.com.

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