Value of mandatory testing for human immunodeficiency virus in a sub-Saharan hospital population

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome ( AIDS) are currently hyperendemic in sub-Saharan Africa. HIV and AIDS have a special impact on working-age populations, economic resources, certain ill nesses, and health care facilities. Assessment of HIV serostatus of hospita lized patients is rarely performed, however, because of a reluctance to int rude on patient confidentiality, a perceived lack of benefit (no antiretrov iral therapy is available), and societal denial,We evaluated the effect on hearth care of HIV testing of patients routinely admitted to medical wards in the 2 major city hospitals in Harare, Zimbabwe. Of 196 patients tested, 58% were HIV positive with strong associations with infectious diseases, an d with youth and weight loss, but not with cardiac, pulmonary, endocrinolog ic, or renal diagnoses, and not with rural Versus urban location, occupatio n, sex, mortality, or cost of hospitalization. The clinical estimate of pat ients' HIV serostatus was largely inaccurate. Mandatory HIV testing of all hospitalized patients would improve diagnosis of infectious diseases, clari fy patient prognosis, allow for individual counseling with regard to HIV pr evention, and focus national hearth efforts by providing alarming, realisti c statistics.