Factors associated with human immunodeficiency virus testing among tuberculosis patients receiving treatment at health facilities in Uganda

SETTING: One pen-urban and four rural districts in Uganda. OBJECTIVES: To determine the level of and factors associated with human immunodeficiency virus (HIV) testing among tuberculosis (TB) patients. DESIGN: A cross-sectional study was conducted in five selected districts from August to November 2007. Patients aged >= 18 years returning for TB treatment refills at facilities offering TB and HIV services were included. Patients were excluded if they were very sick or unable to speak English or any of the local study languages. The outcome was self-reported HIV testing after TB diagnosis, validated using clinic registers. RESULTS: Of 261 patients analysed, 169 (65%) had been tested for HIV following TB diagnosis. In a multi-variate analysis, age >45 years (OR 0.27, 95% CI 0.08-0.87), not receiving information about the TB-HIV association (OR 0.35, 95% CI 0.15-0.77), not being offered HIV testing by health provider (OR 0.02, 95% CI 0.006-0.042), dissatisfaction with privacy (OR 2.49, 95% CI 1.11-5.55) and spending 30-60 min at the clinic (OR 4.48, 95% CI 1.66-12.10) significantly influenced level of HIV testing. CONCLUSION: The level of HIV testing among TB patients was suboptimal, as per policy all patients should be tested. The Uganda Ministry of Health should continue to scale-up HIV testing and other collaborative TB-HIV services at health facilities.