RECRUITMENT TO A TRIAL OF TUBERCULOSIS PREVENTIVE THERAPY FROM A VOLUNTARY HIV TESTING CENTER IN LUSAKA - RELEVANCE TO IMPLEMENTATION

To determine the number of clients attending for voluntary human immun odeficiency virus (HIV) testing who are able to enter a trial of preve ntive therapy for tuberculosis, and the factors that determine who rec eives therapy, we studied 475 consecutive people attending for an HIV test at Lusaka's first voluntary HIV testing centre and the preventive therapy study clinic at the University Teaching Hospital, Lusaka, Zam bia. Semi-structured interviews were conducted by counsellors and coll ated with recruitment data from the trial: Two hundred and twenty-five people were seropositive, of whom 201 returned to collect their resul ts; 77 (38%) of these (16% of the total number screened) entered the t rial. Reasons for not entering the trial included exclusion by trial p rotocol(30), including 18 who had active tuberculosis; psychological a djustment to a positive result (27); death (6); worries about confiden tiality (3); the experimental nature of the trial (12); attitudes of s taff in the hospital (5); and cost of transport (7). Targeting prevent ive therapy at those who are already choosing to be tested for HIV see ms appropriate and may be cost-effective. Although visiting a hospital may deter some people, the prevalence of active tuberculosis among th is group emphasized the importance of arranging adequate screening fac ilities.