ArticleTropical medicine & international health : TM & IH2016
Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counselling (PITC) in Malawi.
Article in Tropical medicine & international health : TM & IH, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study.BMC public health · 2021Trial
- Very low HIV positivity on paediatric surgical wards in Mozambique: Implications for inpatient provider-initiated testing programmes.Southern African journal of HIV medicine · 2024Article
- Country adoption of WHO 2019 guidance on HIV testing strategies and algorithms: a policy review across the WHO African region.BMJ open · 2023Article
- Effectiveness of provider-initiated versus client-initiated HIV testing by different health facility departments in Northern Tanzania.AIDS research and therapy · 2023Article
- Facility-based HIV self-testing strategies may substantially and cost-effectively increase the number of men and youth tested for HIV in Malawi: results from an individual-based mathematical model.Journal of the International AIDS Society · 2022Article
- Monitoring and evaluation of HIV screening and testing of hospitalized infants and their mothers.Public health action · 2022Article
- Facilitators and barriers to implementing provider-initiated HIV counselling and testing at the clinic-level in Ekurhuleni District, South Africa.Implementation science communications · 2022Article
- Prediction of HIV status based on socio-behavioural characteristics in East and Southern Africa.PloS one · 2022Article
- Digitally supported HIV self-testing increases facility-based HIV testing capacity in Ekurhuleni, South Africa.Southern African journal of HIV medicine · 2022Article
- Treatment-adjusted prevalence to assess HIV testing programmes.Bulletin of the World Health Organization · 2021Article
- Use of machine learning techniques to identify HIV predictors for screening in sub-Saharan Africa.BMC medical research methodology · 2021Article
- Individual- and Facility-Level Factors Associated with Facility Testing among Men in Malawi: Findings from a Representative Community Survey.Diagnostics (Basel, Switzerland) · 2021Article
- Implementation science in maternity care: a scoping review.Implementation science : IS · 2021Article
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- Perceived Barriers Toward Provider-Initiated HIV Testing and Counseling (PITC) in Pediatric Clinics: A Qualitative Study Involving Two Regional Hospitals in Dar-Es-Salaam, Tanzania.HIV/AIDS (Auckland, N.Z.) · 2020Article
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- Clinical and operational factors associated with low pediatric inpatient HIV testing coverage in Mozambique.Public health action · 2019Article
- Strengthening provider-initiated testing and counselling in Zimbabwe by deploying supplemental providers: a time series analysis.BMC health services research · 2019Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo assess implementation of provider-initiated testing and counselling (PITC) for HIV in Malawi.
methodsA review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected programme data.
resultsReported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5293/5615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics and 49.4% (6871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71) and inadequate number of HIV counsellors (32/71) while providers from inpatient units cited the inability to test on weekends.
conclusionsVarious models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests that routine PITC is feasible. These results underscore the need to develop clear, standardised PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure and human resources.
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