A clinical audit of provider-initiated HIV counselling and testing in a gynaecological ward of a district hospital in KwaZulu-Natal, South Africa
Abstract
Background. Early initiation of antiretroviral therapy reduces transmission of HIV and prolongs life. Expansion of HIV testing is therefore pivotal in overcoming the HIV pandemic. Provider-initiated counselling and testing (PICT) at first clinical contact is one way of increasing the number of individuals tested. Our impression is that not all patients admitted to a general gynaecological ward are offered PICT.
Objective. To assess whether patients admitted to a gynaecological ward in a district-level hospital in KwaZulu-Natal, South Africa, are being offered PICT.
Methods. We conducted a retrospective chart review over an 8-month period. Patients who had a hospital stay of 3 days were enrolled. The case records were reviewed and relevant data, including demographic information and whether the patients were offered HIV testing, were recorded.
Results. Of 1 014 patients, 451 reported that they had been tested previously; 98 (21.7%) of these were HIV-infected. There were therefore 916 patients (563 not tested previously and 353 who reported that they had tested negatively previously) who should have been offered PICT. Of these, 157 (17.1%) were offered it; 116 (73.9%) accepted and 41 declined. Forty-five (38.8%) tested positive.
Conclusion. A large number of patients who stayed for 3 days in a gynaecology ward of a district-level hospital were not offered PICT. However, the high rate of HIV infection in those who accepted the offer of testing strengthens the case for PICT.
Objective. To assess whether patients admitted to a gynaecological ward in a district-level hospital in KwaZulu-Natal, South Africa, are being offered PICT.
Methods. We conducted a retrospective chart review over an 8-month period. Patients who had a hospital stay of 3 days were enrolled. The case records were reviewed and relevant data, including demographic information and whether the patients were offered HIV testing, were recorded.
Results. Of 1 014 patients, 451 reported that they had been tested previously; 98 (21.7%) of these were HIV-infected. There were therefore 916 patients (563 not tested previously and 353 who reported that they had tested negatively previously) who should have been offered PICT. Of these, 157 (17.1%) were offered it; 116 (73.9%) accepted and 41 declined. Forty-five (38.8%) tested positive.
Conclusion. A large number of patients who stayed for 3 days in a gynaecology ward of a district-level hospital were not offered PICT. However, the high rate of HIV infection in those who accepted the offer of testing strengthens the case for PICT.
http://dx.doi.org/10.7196/sajog.603
