Factors associated with HIV testing among patients seeking emergent injury care in Kigali, Rwanda

African Journal of Emergency Medicine

Vincent Ndebwanimana¹  Catalina Gonzalez Marques²  Chantal Uwamahoro³  Spandana Jarmale⁴  Doris Uwamahoro⁴  Andrew Stephen⁵  Mediatrice Niyonsaba⁵  Adam R. Aluisio⁵  Zeta Mutabazi⁵  Oliver Y. Tang⁶  Aly Beeman⁷ 

[1] Corresponding author.;Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, KN 4 Ave, Kigali, Rwanda;Women's Hospital, Boston, MA, USA;Brown University Warren Alpert Medical School, Providence, RI, USA;Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, KN 4 Ave, Kigali, Rwanda;;Department of Emergency Medicine, Brigham &Department of Emergency Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA;

关键词: Rwanda;    HIV;    Emergency care;    Global health;    Low- and middle-income countries;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: Emergency centres (ECs) can be important access points for HIV testing. In Rwanda, one in eight people with HIV are unaware of their infection status, which impedes epidemic control. This could be addressed via increased testing. This cross-sectional study evaluated factors associated with EC-based HIV testing among injured patients at the Centre Hospitalier Universitaire de Kigali (CHUK), in Kigali, Rwanda. Methods: Adult injury patients were prospectively enrolled between January-June 2020. Trained study personnel collected data on demographics, injury aspects, treatments, HIV testing, and disposition. The primary outcome was the completion of EC-based HIV testing. Differences between those receiving and those not receiving testing were assessed. Regression models yielding adjusted odds ratios with associated 95% confidence intervals (CI) were calculated to quantify magnitudes of effect. Results: Among 579 patients, the majority were under 45 years of age (78.1%) and male (74.4%). The most common mechanism of injury was road traffic accidents (50.3%). EC discharge occurred in 54.4% of cases. HIV testing was performed in 221 (38.2%) cases, of which 5.9% had a positive result. HIV testing was more likely among males (aOR=1.69, 95% CI: 1.02–2.78; p=0.04), cases transported by prehospital services (aOR=2.07, 95% CI: 1.28-3.35; p=0.003) and those receiving surgical consultation (aOR=3.13, 95% CI: 1.99-4.94; p<0.001). Cases with lower acuity were less likely to be tested (OR=0.70, 95% CI: 0.55-0.90; p=0.004), as were those discharged (OR=0.28, 95% CI: 0.18-0.43; p<0.001). Conclusion: In the population studied, most patients did not undergo HIV testing. EC-based physician directed testing was more likely among male patients and patients with greater care needs. These results may inform approaches to increase EC-based testing services in Rwanda and other similar settings with high HIV burdens.

【 授权许可】

Unknown