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TB Notes Newsletter

No. 3, 2005

TB Epidemiologic Studies Consortium Update

Task Order 4 Update:
HIV Counseling, Testing, and Referral for TB Contacts

The New York City Department of Health and Mental Hygiene (NYCDOHMH) Bureau of TB Control implemented TBESC Task Order 4 in collaboration with CDC. The study was designed to identify and target HIV-infected contacts to infectious TB patients, a group at great risk of developing TB disease. In 2001 and again in 2003, CDC guidelines stated that HIV counseling, testing, and referral (CTR) should be routinely recommended to TB suspects, TB patients, and their contacts.1,2 However, for many TB programs, provision of HIV testing has not been a routine part of contact investigation procedures.

Close contacts reported in Manhattan, New York City, from December 2002 through November 2003 were offered HIV CTR through the study. Objectives were to increase HIV CTR and knowledge of HIV serostatus among close contacts, screen all HIV-infected contacts for active TB, prevent progression to active TB among HIV-infected contacts through LTBI treatment, prevent additional AIDS opportunistic infections, and provide better care of persons living with HIV disease by referring them to and assisting them access care for HIV infection.

Data collection was finalized in February 2004. Analyses included a comparison of contacts who had received HIV tests, either recently or previously, to those contacts who had not received HIV tests; an assessment of factors associated with acceptance of testing; a description of TB outcomes; and an estimate of project costs. An article has been prepared for submission to a peer-reviewed journal. Of 614 contacts, 569 (93%) were provided information about HIV infection and offered HIV CTR. Of the 569, 29% were newly tested, 10% were previously HIV-tested (with 24 found to be HIV infected), and 61% were not tested for HIV. Newly HIV-tested contacts (vs. not tested) were more likely to be aged 18–24, Hispanic, or non-Hispanic black. Of eligible HIV-infected contacts, 56% started and half completed treatment for latent TB infection. It cost $1 per patient to provide HIV information and $5–$8 to offer HIV CTR. The project increased HIV counseling and testing of high-risk groups and improved TB screening of those found to be HIV-infected.

—Reported by Suzanne Marks, MPH
Div of TB Elimination
and Jiehui Li, MBBS, MS
NYC Dept. of Health and Mental Hygiene


  1. CDC. Revised guidelines for HIV counseling, testing, and referral. MMWR 2001; 50 (RR 19): 1-57.
  2. CDC. Advancing HIV prevention: new strategies for a changing epidemic – United States, 2003. MMWR 2003; 52(15): 329-332.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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