HIV testing in a South African emergency department: a missed opportunity

Background: South Africa (SA) has the highest burden of HIV infection in the world. Even though HIV testing is mandated in all hospital-based facilities in SA, it is rarely implemented in the emergency department (ED). EDs are episodic care centers that provide care to large volumes of undifferentiated patients for short periods of time, and may treat undiagnosed HIV-infected patients not captured through standard clinic based screenings. Methods and Findings: In this prospective study, we implemented the National South African HIV testing guidelines, including 24-hours a day counselor initiated HIV Counseling and Testing (HCT), at Frere Hospital in the Eastern Cape from September 1 to November 30, 2016. All patients that presented for care in the ED during the study period, and who were clinically stable and fully conscious, were eligible to be approached by HCT staff to receive a rapid point-of-care HIV test. A total of 2355 of the 9583 (24.6%) patients that presented to the ED for ca...

背景：南非（South Africa, SA）是全球HIV（人类免疫缺陷病毒，Human Immunodeficiency Virus）感染负担最重的国家。尽管南非所有医院内设机构均已强制推行HIV检测，但该检测在急诊科（Emergency Department, ED）中的实施率极低。急诊科作为急诊诊疗中心，可在短时间内为大量未明确诊断的患者提供诊疗服务，还可能接诊未通过标准门诊筛查发现的尚未确诊的HIV感染者。方法与结果：本项前瞻性研究于2016年9月1日至11月30日在东开普省弗雷尔医院开展，落实了南非国家HIV检测指南，其中包括由咨询师主动发起的24小时HIV咨询与检测（HIV Counseling and Testing, HCT）。研究期间所有在急诊科就诊、临床状态稳定且意识完全清醒的患者，均可由HCT工作人员提供快速床旁HIV检测（rapid point-of-care HIV test）服务。共计9583名前往急诊科就诊的患者中，有2355名（占比24.6%）...