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[Counseling and HIV-testing among hospital patients in Arusha and Kilimanjaro].

Authors
Type
Published Article
Journal
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
Publication Date
Volume
115
Issue
26
Pages
3286–3288
Identifiers
PMID: 7482463
Source
Medline
Keywords
License
Unknown

Abstract

The MUTAN (Tanzanian Norwegian AIDS Project) virology program has comprised research, intervention, surveillance, and education as part of the Tanzanian National AIDS Control Program. The introduction of a HIV/AIDS counseling service at the regional hospitals of Arusha and Kilimanjaro during 1990-92 is described. Patients were given pre-test, post-test, and follow-up counseling by 15 trained counselors from the hospitals. In addition, all doctors underwent a 2-day training course in counseling. A total of 1194 patients were included in the pretest counseling of whom 1133 (95%) gave informed consent to be tested. 930 persons (78%) were directed to doctors in the hospitals. 15% of the 1194 turned to counselors on their own initiative. Of 1108 persons who had test results, 684 (61.7%) were HIV positive. Out of 1133 patients who gave informed consent, 765 (360 men and 405 women) were evaluated. No symptoms were found in 17.3% of men and 35.7% of women; earlier signs of AIDS were verified in 59.3% of men and 67.7% of women; clinical symptoms of AIDS were revealed by 90.4% of men and 85.5% of women; and terminal AIDS was diagnosed in 65.5% of men and 83.3% of women. The data showed that the clinical diagnosis of mistaken early AIDS was very uncertain; however, there was a high degree of correspondence between the clinical diagnosis of manifest AIDS and the serological results. In increasing order the psychosocial reactions to the positive test results were: shock, denial, anger, relief (p .05), guilt feeling (p .05), fright/anxiety, dejection/sorrow, and acceptance. This mode of counseling became routine after 5 years in the two hospitals. About two-thirds of the HIV positive patients from the 1990-92 period died, but the counseling system allows the follow-up of HIV-positive patients and their families in devising methods for fighting the epidemic.

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