Open access clinic providing HIV-I antibody results on day of testing: The first twelve months

Abstract

Objectives - To determine the sociodemographic profile, risk category, and prevalence of HIV-I infection among people attending a clinic providing counselling, medical advice, and results of HIV-I antibody testing on the day of consultation; to determine the stage of infection and peripheral blood CD4 cell count among attenders with detectable HIV-I antibodies. Design - Analysis of prospectively collected data for the 12 months from March 1989. Setting - Same day testing clinic run by the HIV/AIDS team at an urban teaching hospital. Patients - 561 consecutive people choosing to attend and proceeding to HIV-I testing. Results - The demand for the service caused it to run to capacity within six months. The median age of those attending was 28 years and 65% (364 patients) were male. The overall prevalence of HIV-I infection was 3·9% (22 patients). The greatest prevalence was in men reporting their primary risk as homosexual contact(11·9%, 13/109). The median CD4 cell count in the 22 patients who had detectable HIV-I antibodies was 0·31×109 cells/1 (normal range 0·5×109/1 to 1·2×109/1). Twenty of these patients were asymptomatic (Centers for Disease Control stages II or III), 14 had CD4 cell counts below 0·5×109/1. Conclusions - There is a recognisable demand for a service providing rapid results of HIV-I antibody testing in this setting. The overall seroprevalence of 3·9% is comparable with the 5·8% reported from freestanding clinics in the United States. Most patients with HIV-I antibodies detected in this way are asymptomatic but could benefit from early medical intervention because of low CD4 cell counts.