Human immunodeficiency virus counseling, testing, and referral of close contacts to patients with pulmonary tuberculosis: feasibility and costs.
BACKGROUND
We aimed to increase human immunodeficiency virus (HIV) counseling, testing, referral (CTR), and knowledge of HIV serostatus of close contacts of tuberculosis patients and improve tuberculosis screening and treatment of HIV-infected contacts.


METHODS
Of close contacts to infectious tuberculosis patients reported from December 2002 to November 2003, investigators (1) offered HIV CTR, (2) identified factors associated with HIV testing, and (3) assessed study costs.


RESULTS
Of 614 contacts, 569 (93%) were provided HIV information and offered HIV CTR. Of the 569, 58 (10%) were previously HIV tested; 165 (29%) were newly HIV tested; and 346 (61%) were not tested. None of the 165 newly HIV tested contacts were HIV infected. Contacts more likely to be newly HIV tested (vs not tested) included those aged 18-24, Hispanic, or non-Hispanic Black. Of 24 HIV-infected contacts, 71 percent received chest-radiograph screening for tuberculosis disease; 56 percent of 18 eligible for latent-tuberculosis-infection treatment started and half completed. It cost $1 per patient to provide HIV information and $5-$8 to offer HIV CTR.


CONCLUSIONS
The project increased HIV CTR of close contacts of infectious tuberculosis patients. The important factor for success in knowing contacts' HIV serostatus was simply for TB program staff to ask about it and offer the test to those who did not know their status.
Li
Jiehui
J
Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, New York, NY 1007, USA. jli1@health.nyc.gov
Marks
Suzanne M
SM
Driver
Cynthia R
CR
Diaz
Francisco A
FA
Castro
Alejandro F
AF
de Regner
Annette Figueroa
AF
Gibson
Aurelia E
AE
Dokubo-Okereke
Kinta
K
Munsiff
Sonal S
SS
D015492:AIDS Serodiagnosis / Q000191:economics / Q000706:statistics & numerical data*; D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D016358:Contact Tracing / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics / Q000706:statistics & numerical data*; D018563:Disease Notification / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D011635:Public Health Administration / Q000191:economics / Q000379:methods*; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*