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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
  • Acquired Immunodeficiency Syndrome--Prevention And Control
  • Africa
  • Africa South Of The Sahara
  • Clinic Activities
  • Counseling
  • Counselors
  • Delivery Of Health Care
  • Developed Countries
  • Developing Countries
  • Diseases
  • Eastern Africa
  • English Speaking Africa
  • Europe
  • Examinations And Diagnoses
  • Health
  • Health Facilities
  • Hiv Infections
  • Hiv Serodiagnosis
  • Hospitals
  • Laboratory Examinations And Diagnoses
  • Multiregional Analysis
  • Northern Europe
  • Norway
  • Organization And Administration
  • Program Activities
  • Programs
  • Research Methodology
  • Scandinavia
  • Signs And Symptoms
  • Tanzania
  • Viral Diseases

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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