Provider initiated HIV testing and counselling in tuberculosis-HIV collaborative activities: effect on knowledge and perception of tuberculosis patients in Garhwal, Uttarakhand in India

Background: The burden of tuberculosis (TB) is so closely linked to the HIV epidemic that prevention of HIV must become a priority for TB programmes, just as TB care and prevention should be a major concern of HIV/AIDS programmes. The objective of this study was to assess the effect of TB-HIV collaborative activities on knowledge regarding the two diseases and their co-infection among diagnosed TB patients in Garhwal region of Uttarakhand in India.
Methods: A cross sectional study was conducted among 346 patients registered under the Revised National Tuberculosis Control Programme (RNTCP) at selected District Microscopy Centres (DMCs) in four out of seven randomly selected districts of Garhwal region. Information related to socio-demographic profile of the patients, their health variables, knowledge about TB-HIV co-infection and knowledge about access points for care of TB-HIV co-infection was obtained.
Results: The median age of respondents was 33 years, with a slight predominance of males (56.9%). About one fourth of the respondents were illiterate and 60% had a monthly family income of India Rupees 3,000-7,499 (US$=47. 1 - 117.7). While knowledge about preventing transmission of TB by use of a handkerchief was good (97-98%), knowledge regarding proper disposal of sputum was inadequate (11-12%). Knowledge about various modes of transmission of HIV ranged from 44% to 47% with males having better knowledge. Knowledge about asymptomatic period (5.8%) and window period (0.2%) was dismal. More than half (55.2%) were ignorant about symptoms of HIV/AIDS. Ignorance about TB- HIV co-infection was high (92%).
Conclusion: Knowledge of patients registered under RNTCP was lacking with respect to both TB and HIV infection as well as about co-infection, with ignorance rates being higher among females. The findings highlight the fact that the patients were left un-informed and un-educated even after having an interaction with the health care workers at two different places, which should not be missed, for educating patients on relevant issues related to TB, HIV & co-infection.

Keywords
Tuberculosis; HIV/AIDS; co-infection; collaborative activities; knowledge; India