Experience of offering HIV rapid testing to at-risk patients in community health centers in eight Chinese cities.
OBJECTIVE
To explore the feasibility of offering HIV counseling and testing in community health centers (CHCs) and to provide evidence for the HIV/AIDS response in China.


METHODS
Forty-two CHCs were selected from the eight cities that participated in the study. Rapid testing was mainly provided to: clients seeking HIV testing and counseling (HTC); outpatients with high-risk behavior of contracting HIV; inpatients and outpatients of key departments. Aggregate administrative data were collected in CHCs and general hospitals and differences between the two categories were compared.


RESULTS
There were 23,609 patients who underwent HIV testing, accounting for 0.37% of all estimated clinic visits at the 42 sites (0.03%-4.35% by site). Overall, positive screening prevalence was 0.41% (95% confidence interval [CI] 0.33%-0.49%, range 0.00%-0.98%), which is higher than in general hospitals (0.17%). The identification efficiency was 0.22% (95% CI: 0.16%-0.27%) in pilot CHCs, 3.5 times higher than in general hospitals (0.06%) (Chi square test = 95.196, p<0.001). The percentage of those receiving confirmatory tests among those who screened positive was slightly lower in CHCs (73.7%) than in general hospitals (80.1%) (Chi-square test = 17.472, p<0.001). Composition of clients mobilized for testing was consistent with the usage of basic public health and medical services in CHCs. The rate of patients testing HIV positive was higher among patients from key CHC departments (0.68%) than among high-risk Voluntary Counseling and Testing (VCT) clients (0.56%), those participating in outreach activities (0.41%), pregnant women (0.05%), and surgical patients (0.00%).


CONCLUSIONS
This project demonstrates that providing HIV testing services for patients who exhibit high risk behavior has a high HIV case detection rate and that CHCs have the capacity to integrate HTC into routine work. It provides concrete evidence supporting the involvement of CHCs in the expansion of HIV/AIDS testing and case finding.
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Dapeng
D
Zhang
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Sining
S
Meng
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Peng
P
Xu
Beijing Centers for Diseases Control and Prevention, Beijing, China.
Hongyan
H
Lu
Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Minghua
M
Zhuang
Chongqing Center for Disease Control and Prevention, Chongqing, China.
Guohui
G
Wu
Harbin Center for Disease Control and Prevention, Harbin, China.
Yanling
Y
Liu
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Xiaohong
X
Pan
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Hongjing
H
Yan
Hunan Provincial Center for Disease Control and Prevention, Changsha, China.
Xi
X
Chen
Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
Lirui
L
Fan
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Chengmei
C
Li
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaojing
X
Fu
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Jinlei
J
Qi
Shandong Provincial Center for Disease Control and Prevention, Jinan, China.
Lei
L
Han
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Fuchang
F
Ma
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Fan
F
Lv
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Jiangping
J
Sun
D015492:AIDS Serodiagnosis / Q000379:methods* / Q000706:statistics & numerical data*; D000328:Adult; D002681:China / Q000453:epidemiology; D002947:Cities / Q000706:statistics & numerical data*; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult