title: A successful model for rapid triage of symptomatic patients at an HIV testing site in Haiti.
abstract: BACKGROUND
  Attrition from HIV testing to antiretroviral therapy (ART) initiation is high. Strengthening linkages in care from testing to treatment may reduce attrition. This study addresses the question: can social workers accurately identify symptomatic patients during HIV testing and fast-track them for rapid provision of services?
  
  
  METHODS
  This study took place at the Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) in Port-au-Prince, Haiti. We compared symptoms reported by social workers at HIV testing using a checklist to diagnoses made by physicians on an intake exam to determine if social workers could accurately identify symptomatic patients.
  
  
  RESULTS
  Among the 437 HIV-positive patients included in the study, social workers reported stage-associated symptoms in 100% of patients diagnosed with WHO stage 3 or 4 conditions and in 87% of patients with WHO stage 1 or 2 conditions. The sensitivity, specificity, positive predictive value, and negative predictive value of social worker-reported symptoms for the diagnosis of a WHO stage 3 or 4 condition was 100%, 47%, 31%, and 100%, respectively.
  
  
  CONCLUSIONS
  Social workers can identify symptomatic patients at HIV testing and refer them for fast-tracked services. This strategy may increase the rate of ART initiation among eligible patients.
authors.affiliation: Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Morgan C
authors.initials: MC
authors.lastname: Esperance
authors.affiliation: Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Serena P
authors.initials: SP
authors.lastname: Koenig
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Colette
authors.initials: C
authors.lastname: Guiteau
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Homeus
authors.affiliation: Florida International University, Miami, Florida.
authors.forename: Jessy
authors.initials: J
authors.lastname: Devieux
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Jenny
authors.initials: J
authors.lastname: Edouard
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bertrand
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Clovy
authors.initials: C
authors.lastname: Bellot
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti.
authors.forename: Diessy
authors.initials: D
authors.lastname: Decome
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti Center for Global Health, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jean W
authors.initials: JW
authors.lastname: Pape
authors.affiliation: Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Harry Truman Boulevard, Port-au-Prince, Haiti patsevere@gheskio.org.
authors.forename: Patrice
authors.initials: P
authors.lastname: Severe
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D000068217:Social Workers; D014218:Triage / Q000458:organization & administration*
chemical_list: D044966:Anti-Retroviral Agents
keywords: AIDS; Attrition; HIV; Haiti; Human resources; Retention in care