A successful model for rapid triage of symptomatic patients at an HIV testing site in Haiti

Int Health. 2016 Mar;8(2):96-100. doi: 10.1093/inthealth/ihv042. Epub 2015 Jul 14.


Background: Attrition from HIV testing to antiretroviral therapy (ART) initiation is high. Strengthening linkages in care from testing to treatment may reduce attrition. This study addresses the question: can social workers accurately identify symptomatic patients during HIV testing and fast-track them for rapid provision of services?

Methods: This study took place at the Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) in Port-au-Prince, Haiti. We compared symptoms reported by social workers at HIV testing using a checklist to diagnoses made by physicians on an intake exam to determine if social workers could accurately identify symptomatic patients.

Results: Among the 437 HIV-positive patients included in the study, social workers reported stage-associated symptoms in 100% of patients diagnosed with WHO stage 3 or 4 conditions and in 87% of patients with WHO stage 1 or 2 conditions. The sensitivity, specificity, positive predictive value, and negative predictive value of social worker-reported symptoms for the diagnosis of a WHO stage 3 or 4 condition was 100%, 47%, 31%, and 100%, respectively.

Conclusions: Social workers can identify symptomatic patients at HIV testing and refer them for fast-tracked services. This strategy may increase the rate of ART initiation among eligible patients.

Keywords: AIDS; Attrition; HIV; Haiti; Human resources; Retention in care.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage*
  • Anti-Retroviral Agents / therapeutic use
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • Haiti / epidemiology
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Social Workers*
  • Triage / organization & administration*


  • Anti-Retroviral Agents