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      Early Determination of Human Immunodeficiency Virus Status by Routine Voluntary Counseling and Testing in Benin City, Nigeria

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          Abstract

          Background:

          To reduce the burden of human immunodeficiency virus (HIV), the popularization of voluntary counseling and testing (VCT) for early determination of human immunodeficiency virus status will be of immense benefit.

          Aim:

          To evaluate the uptake of voluntary counseling and testing and sero-prevalence of human immunodeficiency virus among status naïve outpatients and self-presenting VCT clients in Benin City, Nigeria.

          Materials and Methods:

          This study was carried out in the period of May 2010 to April 2011 at the University of Benin teaching hospital, Benin City. Subjects who consented were included and screened for HIV. Pre and post-test counseling was done following the world health organization guidelines.

          Results:

          Out of 10,533 subjects (7783 outpatients and 2750 self-presenting VCT clients) counseled for VCT, a total of 4651(44.2%) subjects; (3971(51.0%) outpatients and 680 (24.7%) self-presenting VCT clients), consented and accepted HIV VCT. Overall HIV prevalence was 6.4%. 270 (6.8%) outpatients and 29 (4.3%) self-presenting VCT clients were HIV positive. HIV was significantly associated with female gender among the outpatients ( P<0.001).

          Conclusion:

          VCT uptake was low; the sero-prevalence of HIV was high. The need to employ an expanded and more purpose oriented public enlightenment campaign on the usefulness of HIV VCT should be a priority for HIV control agencies in our area.

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          Most cited references30

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          Emerging concepts in the immunopathogenesis of AIDS.

          Daniel Douek, Mario Roederer, R Koup (2008)
          There is an intense interplay between HIV and the immune system, and the literature is replete with studies describing various immunological phenomena associated with HIV infection. Many of these phenomena seem too broad in scope to be attributable either to HIV-infected cells or to the HIV-specific immune response. Recently, a more fundamental understanding of how HIV affects various T cells and T cell compartments has emerged. This review covers the role of immune activation in HIV immunopathogenesis, how that activation could be mediated directly by HIV replicating within and damaging the gut mucosal barrier, how HIV affects multiple T cell functions and phenotypes, and how chronic HIV replication induces immune modulatory pathways to negatively regulate certain functions in HIV-specific T cells.
          Article 0 comments Cited 148 times – based on 0 reviews     Review now
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            Acceptability of routine HIV counselling and testing, and HIV seroprevalence in Ugandan hospitals.

            N. Sewankambo, Betty Abang, Rhoda Wanyenze … (2008)
            Mulago and Mbarara hospitals are large tertiary hospitals in Uganda with a high HIV/AIDS burden. Until recently, HIV testing was available only upon request and payment. From November 2004, routine free HIV testing and counselling has been offered to improve testing coverage and the clinical management of patients. All patients in participating units who had not previously tested HIV-positive were offered HIV testing. Family members of patients seen at the hospitals were also offered testing. Data collected at the 25 participating wards and clinics between 1 November 2004 and 28 February 2006 were analysed to determine the uptake rate of testing and the HIV seroprevalence among patients and their family members. Of the 51,642 patients offered HIV testing, 50,649 (98%) accepted. In those who had not previously tested HIV-positive, the overall HIV prevalence was 25%, with 81% being tested for the first time. The highest prevalence was found in medical inpatients (35%) and the lowest, in surgical inpatients (12%). The prevalence of HIV was 28% in the 39,037 patients who had never been tested before and 9% in those who had previously tested negative. Of the 10,439 family members offered testing, 9720 (93%) accepted. The prevalence in family members was 20%. Among 1213 couples tested, 224 (19%) had a discordant HIV status. In two large Ugandan hospitals, routine HIV testing and counselling was highly acceptable and identified many previously undiagnosed HIV infections and HIV-discordant partnerships among patients and their family members.
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              Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda.

              Fred Nalugoda, Joseph Matovu, R. Gray … (2005)
              To assess the acceptance of voluntary HIV counseling and testing (VCT) and the effects of VCT on sexual risk behavior and HIV acquisition in Rakai, Uganda. In a rural cohort, 10 694 consenting adults were interviewed, provided blood for HIV testing and were offered free VCT by community resident counselors. The proportions receiving VCT and the adjusted risk ratio (adj. RR) of VCT acceptance were estimated by log binomial regression. Risk behaviors and HIV incidence per 100 person-years (PY) in HIV-negative acceptors and non-acceptors of VCT were assessed prospectively. Although 93% initially requested HIV results, 62.2% subsequently accepted VCT. VCT acceptance was lower among persons with no prior VCT [Adj. RR = 0.88; 95% confidence interval (CI), 0.85-0.90], individuals with primary education (adj. RR = 0.94; 95% CI, 0.90-0.99) or higher (adj. RR = 0.91; 95% CI, 0.87-0.97), individuals who were HIV-positive (adj. RR = 0.72; 95% CI, 0.68-0.76), and persons reporting condom use in the past 6 months (inconsistent users, adj. RR = 0.95; 95% CI, 0.90-0.99; consistent users, adj. RR = 0.88; 95% CI, 0.82-0.95). VCT acceptance was higher among the currently married (adj. RR = 1.14; 95% CI, 1.08-1.20) and previously married (adj. RR = 1.11; 95% CI, 1.04-1.18). Receipt of results was not significantly associated with age, gender, and self-perception of HIV risk. There were no significant differences in sexual risk behaviors, or in HIV incidence between acceptors (1.6/100 PY) and non-acceptors (1.4/100 PY) of VCT. In this rural cohort where VCT services are free and accessible, there is self-selection of individuals accepting VCT, and no impact of VCT on subsequent risk behaviors or HIV incidence.
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                Author and article information

                Journal
                Journal ID (nlm-ta): N Am J Med Sci
                Journal ID (publisher-id): NAJMS
                Title: North American Journal of Medical Sciences
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 2250-1541
                ISSN (Electronic): 1947-2714
                Publication date (Print): February 2012
                Volume: 4
                Issue: 2
                Pages: 99-103
                Affiliations
                [1 ] Department of Medical Microbiology, University of Benin Teaching Hospital, P.M.B. 1111, Benin City
                [2 ] Department of Chemical Pathology, University of Benin Teaching Hospital, P.M.B. 1111, Benin City
                [3 ] Federal Capital Territory Administration (FCTA), Medical Microbiology/PEPFAR laboratory, FCT Wuse District Hospital, P.M.B 24, Abuja, Nigeria
                Author notes
                Address for correspondence: Mr. Favour Osazuwa, Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Nigeria. E-mail: osazuwafavour@ 123456yahoo.com
                Article
                Publisher ID: NAJMS-4-99
                DOI: 10.4103/1947-2714.93378
                PMC ID: 3296328
                PubMed ID: 22408757
                SO-VID: 09cb72b4-e078-4099-bb6d-01d4d57887cc
                Copyright © Copyright: © North American Journal of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: voluntary counseling and testing,self-presenting vct clients,vct uptake,hiv sero-prevalence,outpatients
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: voluntary counseling and testing, self-presenting vct clients, vct uptake, hiv sero-prevalence, outpatients

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