Background:  The majority of hospital patients in Uganda receive supplemental supportive care from family members while hospitalized. HIV testing for family members of HIV⁺ patients identifies HIV-infected household members, enhances disclosure and testing of spouses, and increases support for the entire family, therefore enhancing family access to HIV-related services. We evaluated the provision of HIV testing services for patients’ family members in 2 large Ugandan hospitals.

Methods:  HIV testing was offered to spouses, parents of children, and other family members of both HIV^– and HIV⁺ patients who were tested through the routine HIV testing program at Mulago and Mbarara Teaching Hospitals. We analyzed program data from April 2005 through June 2006 to estimate the HIV prevalence among tested family members and discordance rates among those who received couples’ HIV counseling and testing.

Results:  Overall, 17,371 family members of 74,539 patients were tested, 70% were first-time testers; family members included spouses (14%), fathers (7%) and mothers (45%) of pediatric patients, and other household members, eg, sisters and brothers (34%). Of the family members tested, 98% received post-test counseling. Overall HIV prevalence among family members was 19%; 27% among spouses, 18% among mothers and 11% among fathers of pediatric patients, and 16% among other household members. Of 1785 couples tested, 303 (17%) were discordant. Among the 303 HIV⁺ discordant couple members, 229 (75%) were males. Of the 421 HIV⁺ patients tested together with their spouses, 39% had HIV-uninfected spouses.

Conclusions:  Routine offering of HIV testing to family members of patients identifies many additional HIV infections and discordant relationships. This innovative approach to increasing access to HIV prevention, care, and treatment for families merits expansion.