Two and a half years of routine HIV testing in Botswana.
BACKGROUND
Botswana was the first African country to introduce routine HIV testing (RHT).


OBJECTIVE
To report program data for the first 2.5 years of RHT.


METHODS
RHT was introduced in 2004. Rapid HIV tests were introduced later the same year and are widely available. The main criteria for RHT are symptoms of HIV/AIDS, pregnancy, sexually transmitted infection, and attendance for medical examination. Testing may also be self-initiated.


RESULTS
There has been a rapid scale-up of RHT. A total of 60,846 persons were tested through RHT in 2004 versus 157,894 in 2005 and 88,218 in the first half of 2006. Testing rates in the population through RHT were 40 per 1000 persons, 93 per 1000 persons, and 104 per 1000 persons, respectively. In 2005, 89% of those offered testing accepted, with 69% of those tested being female and 31% male. The proportion of men who tested HIV-positive was 34% versus 30% for women. The main reasons for testing in 2005 were patient's wish (50%), pregnancy (25%), medical examination (7%), clinical suspicion (6%), and sexually transmitted infection (2%). Attendance at voluntary counseling and testing centers has increased parallel to the scale-up of RHT.


CONCLUSIONS
RHT has been widely accepted by the population, and no adverse effects or instances have been reported. It has provided increased access to preventive services and earlier assessment for antiretroviral treatment. We believe the benefits of RHT clearly outweigh the risks.
Steen
Tore W
TW
Department of HIV/AIDS Prevention and Care, Ministry of Health, Gaborone Botswana. tsteen@gov.bw
Seipone
Khumo
K
Gomez
Florindo de la Hoz
Fde L
Anderson
Marina G
MG
Kejelepula
Marble
M
Keapoletswe
Koona
K
Moffat
Howard J
HJ
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001902:Botswana; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D015203:Reproducibility of Results; D013997:Time Factors