Provider-initiated HIV testing and counselling for TB in low HIV prevalence settings: is it worthwhile?

BACKGROUND: We assessed the HIV-positive yield of offering provider-initiated HIV testing and counselling (PITC) for TB and the costs, in Madagascar, which has a low HIV prevalence and a high TB burden. METHODS: A cross-sectional study of routinely collected records from January 2010 to June 2011. RESULTS: A total of 37 596 TB patients were registered in 205 TB centres. HIV testing was available in 95 (46%) of centres where 7524 (40%) of those offered testing accepted it. Only 35 (0.5%) individuals were found HIV positive. Initial costs were about US$1.4 million and annual recurrent costs about US$0.1 million. CONCLUSION: There are concerns of cost investment for countrywide introduction of PITC in a low HIV prevalence setting.