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Diagnosis and counselling of patients with acute HIV infection in South Africa
  1. Benjamin J Wolpaw1,
  2. Catherine Mathews1,2,
  3. Mickey Chopra3,
  4. Diana Hardie4,
  5. Mark N Lurie5,
  6. Karen Jennings6
  1. 1South African Medical Research Council, Health Systems Research Unit, Cape Town, South Africa
  2. 2University of Cape Town, School of Public Health and Family Medicine, Cape Town, South Africa
  3. 3University of the Western Cape, School of Public Health, Bellville, South Africa
  4. 4University of Cape Town, Department of Virology, Cape Town, South Africa
  5. 5Brown University Medical School, Department of Community Health, USA
  6. 6Department of Health, Cape Town, South Africa
  1. Correspondence to Mr Benjamin J Wolpaw, South African Medical Research Council, Health Systems Research Unit, Francie van Zijl Drive, Parowvallei, Cape, PO Box 19070, 7505 Tygerberg, South Africa; Ben.wolpaw{at}


Objectives To identify, diagnose and counsel patients with acute HIV infection (AHI) during routine HIV testing in South Africa.

Methods Patients with sexually transmitted infection and clients undergoing voluntary counselling and testing who were negative on rapid HIV antibody tests at a public youth clinic were recruited to the study and tested using HIV-1 PCR and third-generation ELISA. Results were made available at 1 week. Text message reminders and phone calls were employed to encourage patients to return for results. Patients with AHI were additionally visited at home.

Results 902 participants were enrolled over the course of 1 year, reporting high levels of sexual risk behaviour, including 66.7% who did not use a condom at last sex. Six (0.67%) were diagnosed with AHI. Results and counselling were delivered to 62.3% of participants and all six patients with AHI.

Conclusions It is possible to perform routine diagnosis and counselling for acute HIV infection in a limited-resource setting. Provider outreach to patients may help in delivering results to a high proportion of patients, but will probably add to the already substantial cost of testing.

  • Acute HIV Infection
  • AHI
  • Most at Risk of Transmission (MART)
  • primary HIV infection
  • HIV
  • HIV testing
  • prevention

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  • Funding The research was funded by the Medical Research Council of South Africa.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Cape Town Ethics Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.