Epidemiology of human immunodeficiency virus testing among patients with tuberculosis in North Carolina

Background. Human immunodeficiency virus (HIV) testing is recommended for all patients with tuberculosis (TB). Methods. Surveillance data for all reported cases of TB in North Carolina from 1993 to 1999 were examined to assess HIV testing practices. Results. Of 3,680 TB patients, 3,119 (85%) had HIV testing data reported. Of these, 604 (19%) were not offered HIV testing, 465 (18%) refused testing, 379 (15%) were HIV seropositive, 29 (0.8%) were tested but results were not reported, and 1 (0.03%) had an indeterminate result. Older patients were significantly less likely to be offered HIV testing and more likely to refuse testing. Males and African Americans were more likely to be offered and to accept testing. Conclusions. At least 34% of TB patients in North Carolina from 1993 to 1999 did not receive HIV testing. Patients in higher-risk groups were more likely to be tested, but even within the highest-risk groups, testing was not universal. Health care providers Should offer HIV testing to all individuals with TB.