HIV prevalence among clients with possible clinical signs of HIV infection: using the provider initiated testing and counseling approach.

BACKGROUND: Variations on HIV estimates have been reported using routine antenatal care (ANC) sentinel surveillance and voluntary counseling and testing (VCT). But there have been widespread concerns about the low participation rates of ANC and the slow uptake of the routine VCT in many parts of sub-Saharan Africa including Ethiopia. Thus estimates of HIV prevalence based on provider initiated HIV testing and counseling (PITC), can improve our understanding of the issues related to uptake, barriers and outcomes of HIV testing and counseling, and to develop and test different models for optimizing the use of voluntary testing and counseling in a way that ensures that people, are not put at risk.

OBJECTIVES: To estimate the prevalence of HIV among out patient department (OPD) clients with possible clinical signs of HIV infection using the provider initiated testing and counseling approach.

METHODS: Institution based cross-sectional study was conducted on 259 OPD clients with possible clinical signs of HIV infection in 12 government health centers in Addis Ababa.

RESULT: The HIV prevalence rate was 37.5% with 95% CI (31.6 - 43.4%). After adjusting for independent variables subjects in age group 35-44 years were about 4 times more likely to be positive for HIV than age group 15-24 years (AOR =3.58; 95% CI=1.31-9.82) and the odds of HIV infection in the 25-34 years was 2.41 (95% CI= 1.01-5.78) higher than age group 15-24. HIV prevalence significantly declines with educational status from 57.4% among illiterates to about 31-34% among those who read and write and with primary and above educational levels. About half of the participants perceived themselves as having risk for HIV, of whom 41.7% were HIV positive, higher than those who perceived no risk (31%), but significantly lower than among those who remained neutral (61%). Those with prior HIV testing were about 2 times less likely to be HIV positive compared to those who had never been tested

CONCLUSION: The relatively high HIV prevalence rate noted in this study indicates how useful the PITC approach is in detecting cases. We recommend that PITC needs to be implemented at all levels of health facilities in Ethiopia.