Emergency Department Plays Critical Part in Diagnosis of HIV in Low-Resource Area

Results from a 2016 study led by Johns Hopkins at Frere Hospital in South Africa indicate that emergency departments (EDs) play a critical role in promoting HIV testing. The HIV epidemic in South Africa, the worst in the word, is exacerbated by a high number of citizens unaware of their HIV status.

Frere Hospital, located in the Eastern Cape, lacks health care resources, which creates difficulty in diagnosing and treating HIV. The study, published in PLOS ONE, covered a 3-month period of offering HIV tests to 2355 patients in the ED for various injuries. From the population, approximately 73% consented to testing, 22% (n = 400) were diagnosed as HIV positive, including 6% who were newly diagnosed. Results from the entire population indicated that 1 in 3 women tested were HIV positive.

“As a region, the Eastern Cape has one of the highest rates of HIV infection in the world,” said Thomas Quinn, MD, professor of medicine at the Johns Hopkins University School of Medicine and the senior author of the paper, in a press release. “This particular study is the first to document the full magnitude of HIV infection in the region, and the eagerness of the people to know whether they are infected with HIV. The government provides access to treatment, making diagnosis a critical component of care.”

In addition to providing easy access to HIV testing, the research team also discovered that hospital counselors were unable to assist a majority of patients because of the lengthy testing process. From all of the information collected, the results indicated that there is a need to develop new testing strategies and study patient self-testing and implementation.

“It’s time for a major paradigm shift for many hospitals and health systems as we define the role of emergency care in low resource environments,” said Bhakti Hansoti, MBChB, PhD, assistant professor of emergency medicine at the Johns Hopkins University School of Medicine.