Enhancing Integration of HIV Testing into TB Control Program and Factors Associated with Refusal of HIV Testing in Taiwan, July 2013-June 2014

Enhancing Integration of HIV Testing into TB Control Program and Factors Associated with Refusal of HIV Testing in Taiwan, July 2013-June 2014

People living with human immunodeficiency virus (PLWH) had 29 times higher risk to develop active tuberculosis (TB) than non-HIV infected persons, and TB was still the leading cause of death among PLWH. Collaborative management of TB/HIV had been recommended by WHO that aimed to reduce the burden of TB and HIV co-infection in affected populations. The TB control program in Taiwan endorsed active HIV counseling and testing, or encouraging HIV testing in TB care facilities by public health staff for TB patients aged 15-49 years old of unknown HIV status since June 27, 2013. A total of 3,533 TB patients were eligible during July 2013 to June 2014 after excluding 63 patients who had been identified HIV co-infection before notification of TB disease. We found that 2,664 TB patients (75.4 %) received HIV testing with the increasing trend of testing proportion during the study period. This intervention identified newly diagnosed HIV infected TB patients and referred them to initiate highly active anti-retroviral therapy (HAART) treatment. Among them, up to 89.7% received HAART. The main reasons that patients refused HIV testing were having low risk to get HIV infection (42.3%); and not important to test HIV (36.1%). In the future, we suggest enhancing TB screening in HIV control program and isoniazid preventive therapy (IPT) for PLWH.