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. 2014 Jan 28;9(1):e86609.
doi: 10.1371/journal.pone.0086609. eCollection 2014.

Experience of offering HIV rapid testing to at-risk patients in community health centers in eight Chinese cities

Dapeng Zhang  1 , Sining Meng  1 , Peng Xu  1 , Hongyan Lu  2 , Minghua Zhuang  3 , Guohui Wu  4 , Yanling Liu  5 , Xiaohong Pan  6 , Hongjing Yan  7 , Xi Chen  8 , Lirui Fan  9 , Chengmei Li  1 , Xiaojing Fu  1 , Jinlei Qi  1 , Lei Han  10 , Fuchang Ma  1 , Fan Lv  1 , Jiangping Sun  1
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Experience of offering HIV rapid testing to at-risk patients in community health centers in eight Chinese cities

Dapeng Zhang et al. PLoS One. .

Abstract

Objective: To explore the feasibility of offering HIV counseling and testing in community health centers (CHCs) and to provide evidence for the HIV/AIDS response in China.

Methods: Forty-two CHCs were selected from the eight cities that participated in the study. Rapid testing was mainly provided to: clients seeking HIV testing and counseling (HTC); outpatients with high-risk behavior of contracting HIV; inpatients and outpatients of key departments. Aggregate administrative data were collected in CHCs and general hospitals and differences between the two categories were compared.

Results: There were 23,609 patients who underwent HIV testing, accounting for 0.37% of all estimated clinic visits at the 42 sites (0.03%-4.35% by site). Overall, positive screening prevalence was 0.41% (95% confidence interval [CI] 0.33%-0.49%, range 0.00%-0.98%), which is higher than in general hospitals (0.17%). The identification efficiency was 0.22% (95% CI: 0.16%-0.27%) in pilot CHCs, 3.5 times higher than in general hospitals (0.06%) (Chi square test = 95.196, p<0.001). The percentage of those receiving confirmatory tests among those who screened positive was slightly lower in CHCs (73.7%) than in general hospitals (80.1%) (Chi-square test = 17.472, p<0.001). Composition of clients mobilized for testing was consistent with the usage of basic public health and medical services in CHCs. The rate of patients testing HIV positive was higher among patients from key CHC departments (0.68%) than among high-risk Voluntary Counseling and Testing (VCT) clients (0.56%), those participating in outreach activities (0.41%), pregnant women (0.05%), and surgical patients (0.00%).

Conclusion: This project demonstrates that providing HIV testing services for patients who exhibit high risk behavior has a high HIV case detection rate and that CHCs have the capacity to integrate HTC into routine work. It provides concrete evidence supporting the involvement of CHCs in the expansion of HIV/AIDS testing and case finding.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart of HTC cascade, testing in CHC's and in general hospitals in 2012.
See this image and copyright information in PMC

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