State wants mandatory HIV test for all patients admitted in emergency departments

You could be tested for HIV if you end up in hospital with any injury

Piece by: John Muchangi
Lifestyle

• According to the Constitution of Kenya 2010, compulsory HIV testing shall be considered unlawful unless otherwise.

• You could be tested for HIV if you end up in hospital with any injury, according to a proposal being considered by the Ministry of Health.

being administered on a patient
HIV test being administered on a patient
Image: File

You could be tested for HIV if you end up in hospital with any injury, according to a proposal being considered by the Ministry of Health.

There is currently no such requirement for trauma patients in Kenya, despite the risk to patients and health workers.

Experts at the ministry, Kenyatta National Hospital and Kenya Medical Research Institute say they have evidence most patients at the accidents and emergency departments readily agree to be tested for HIV.

The specialists offered HIV testing to patients at KNH between March 2 and May 25 last year.

“When offered, acceptance of HIV testing in the population was high, both in the emergency department and inpatient care venues,” they said in a report.

The proportion of patients who turned out positive was higher than in the national average.

However, the experts say this is unsurprising because data from sub-Saharan Africa have shown that patients seeking injury treatments have high burdens of HIV and are often first diagnosed during emergency care evaluations.

“A new diagnosis of HIV was found in 11.4 per cent of emergency department-tested participants,” a report reads.

The report is titled “Assessment of Standard HIV Testing Services Delivery to Injured Persons Seeking Emergency Care in Nairobi, Kenya: A Prospective Observational Study.”

In Kenya, HIV prevalence in the general population is about 4.6 per cent.

The study has not been published in a scientific journal yet but is available on the preprint platform Medrxiv.

An emergency department, also known as an accident and emergency department, receives patients who present without present without prior appointment.

In Kenya, most of them are from road accidents and falls, according to evidence from the MoH.

“Kenya experiences substantial injury burdens which also disproportionately occur in groups highly affected by HIV," the report reads.

"Indicating that emergency department-based HIV programming during commonly sought injury care could be an impactful interface for testing."

Such injuries are particularly common among population groups with a greater likelihood of HIV occurrence. These include young people, Persons Who Inject Drugs, men who have sex with men and sex workers.

“The majority of participants strongly agreed that HIV testing services should be provided during emergency care and that aspects of the environment and care interactions are suitable for emergency department-based testing,” the experts said.

The proportion of newly identified HIV positive people among the participants completing testing was more than two-fold greater than the baseline population prevalence in the study setting.

In Kenya, although HIV prevalence among women (6.6 per cent) in Kenya is double that of men (3.1 per cent), the testing levels of women are much higher.

Separately, the National Aids and STIS Control Programme last year said thousands of Kenyan men are living with HIV but are unaware of their status, researchers say.

The researchers last year said they interviewed and tested 114,776 men for HIV in Kenya and 12 other countries and found large numbers of them who had HIV and did not know it.

“Of those positive, 33.7 per cent were unaware of their HIV-positive status,” the researchers said in findings published in the Journal of Acquired Immune Deficiency Syndrome.

Most of the men who are unaware of the HIV-positive status said they had never been tested for the virus. They accounted for 63 per cent.

Although the HIV prevalence among women (6.6 per cent) in Kenya is double that of men (3.1 per cent), the testing levels of women are much higher.

Recent studies show that nearly 72 per cent of Kenyan women had tested for HIV in the past 12 months and received their results, compared to 45 per cent of men.

The JAIDS study says that targeting men at risk of infection could improve the yield of testing programmes.

“The results from this large sample suggest that many men in sub-Saharan Africa are likely unaware of their HIV-positive status due to the compounding effects of sociodemographic, behavioural and clinical influences,” the authors say.

National Aids and STIS Control Programme and US Centre for Disease Control in Kenya took part in the study.

However, according to the Constitution of Kenya 2010, compulsory HIV testing shall be considered unlawful unless otherwise.

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