Author(s): April MD, Walensky RP, Chang Y, Pitt J, Freedberg KA,
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Abstract BACKGROUND: Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. METHODS: We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. RESULTS: HIV testing rates rose from 4\% in 2001 to 20\% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47\% in 2001 to 28\% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9\%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0\% in 2001 to 68\% in 2006 (P < 0.001). CONCLUSIONS: Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care.
This article was published in J Acquir Immune Defic Syndr
and referenced in Journal of Antivirals & Antiretrovirals