A Window Into the HIV Epidemic from a South African Emergency Department

Abstract The aim of the study was to describe the HIV care continuum in emergency department (ED) patients in the Eastern Cape region of South Africa. This is a cross-sectional, identity-unlinked serosurvey, whereby discarded/excess samples from all patients who had blood drawn during the study period for routine care and sufficient serum remaining were tested for HIV, hepatitis B virus, and hepatitis C virus infection; HIV viral load (VL); and presence of antiretroviral (ARV) drugs. We also estimated cross-sectional incidence using the Limiting-Antigen Avidity assay and HIV VL. The study was conducted between September and November 2016 at the Frere Hospital Emergency Department in East London, South Africa. The overall HIV prevalence in our study population was 26.9% [95% confidence interval (CI): 25.0–28.8; n = 2,100]. The highest prevalence was observed among females in the 30–39 years age group [60.3% (95% CI: 53.2–67.1)]. HIV prevalence was significantly higher among females compared with males in b...