Objectives 

To describe the implementation of a free, voluntary and confidential HIV counseling and testing program for patients with newly diagnosed tuberculosis at the eight large outpatient tuberculosis centers in Côte d'lvoire, and to present epidemiologic findings on participating patients.

Design 

HIV counseling and testing program with ongoing HIV serosurveillance.

Methods 

HIV counseling and testing services were established at the two tuberculosis centers in Abidjan in 1989 and were extended to six centers in the Côte d'lvoire interior in the first half of 1994.

Characteristics of counseled patients, acceptance rates of HIV testing, and HIV serologic results were analyzed for all eight centers from 1994 to 1996.

Temporal trends in HIV seropositivity rates were examined for the two centers of Abidjan from 1989 to 1996.

Results 

From July 1994 through December 1996,17 946 (91.8%) out of 19594 patients who were counseled at the eight centers in Côte d'lvoire consented to HIV testing, of whom 7749 (43.2%) were HIV-seropositive.

The highest rates of 47.0 and 45.6% were found in the two centers in Abidjan, with rates ranging from 32.9 to 42.4% in the six centers in the interior.

HIV-seropositive tuberculosis patients from each of the 50 districts in Côte d'lvoire were identified.

In Abidjan, the HIV seropositivity rate remained relatively stable among men (46.7% in 1989,48.5% in 1991,43.6% in 1996), but rose sharply among women from 32.7% in 1989 to 50. (...)