Provider-initiated HIV testing and counseling among tuberculosis patients in Kassala, Eastern Sudan

Because of the overlapping global incidence of tuberculosis (TB) and human immunodeficiency virus (HIV) infections, collaborative efforts are required for successful TB and HIV control programs. The current study was conducted at Kassala Hospital in Eastern Sudan and investigated the implementation of provider-initiated HIV testing and counseling (PITC) for patients infected with TB. Using a cross-sectional study design, patients who had been recently diagnosed with TB between January and December 2010 were consecutively enrolled. A total of 858 newly infected TB patients were enrolled in the study. Of these patients, 152 patients (17.7%) were given counseling, and 109 patients (12.7%) underwent HIV testing. The overall HIV infection rate among those tested was 18.3%. From a multivariate analysis, female sex (OR=17.0, 95% CI=8.7-33.1; P<0.001), education level below secondary education (OR=2.6, 95% CI=1.6-4.1; P<0.001), rural residency (OR=1.7, 95% CI=1.3-2.9; P=0.001), and non-governmental employee status (OR=10.4, 95% CI=6.7-16.3; P<0.001) were each associated with lower rates of PITC. Thus, in this setting, the frequency of PITC is low among TB-infected patients and is especially low for females, those of low educational status, and non-governmental employees.