Peer-based Education and the Integration of HIV and Sexual and Reproductive Health Services for Young People in Vietnam: Evidence from a Project Evaluation

Anh D Ngo,Toan H Ha,John Rule,Chinh V Dang,Yuntao Wu

doi:10.1371/journal.pone.0080951

Abstract

IntroductionThis paper reports changes in behavioral outcomes related to the use of HIV testing service of a project that employed peer-based education strategies and integration of HIV voluntary counseling and testing (VCT) and Sexual and Reproductive Health (SRH) services targeting young people aged 15–24 across 5 provinces in Vietnam.MethodsA pre-test/post-test, non-experimental evaluation design was used. Data were collected from cross-sectional surveys of youth and client exit interviews at project supported SRH clinics conducted at baseline and again at 24 months following implementation. The baseline samples consisted of 813 youth and 399 exit clients. The end line samples included 501 youths and 399 exit clients. Z test was used to assess changes in behavioral outcomes.ResultsResults show that there was a significant increase (p<0.05) in the percentage of youth who wanted to obtain a HIV test (from 33% to 51%), who had ever had a test (from 7.5% to 15%), and who had a repeat test in the last 12 months (from 54.5% to 67.5%). Exit client interviews found a nearly five-fold increase in the percentage of clients seeking HIV VCT in their current visit (5.0% vs. 24.5%) and almost two-fold increase in the percentage of those having their last test at a project supported clinic (9.3% vs. 17.8%). There were also positive changes in some aspects of youth HIV/AIDS knowledge, attitudes, and risk perceptions.ConclusionsThis study provides preliminary evidence regarding the benefits of the integration of HIV VCT-SRH services in terms of increased access to HIV services and testing in Vietnam. Benefits of peer-based education regarding increased HIV knowledge were also identified. Further investigations, including experimental studies with assessment of health outcomes and the uptake of HIV testing services, are required to better elucidate the effectiveness and challenges of this intervention model in Vietnam.

Highlights

This paper reports changes in behavioral outcomes related to the use of HIV testing service of a project that employed peer-based education strategies and integration of HIV voluntary counseling and testing (VCT) and Sexual and Reproductive Health (SRH) services targeting young people aged 15–24 across 5 provinces in Vietnam
Access to sexual and reproductive health (SRH) services and access to HIV prevention, treatment, care and support are some of the key targets of the Millennium Development Goals [1]
Since the majority of HIV infections are sexually transmitted or are associated with pregnancy and childbirth [2], linking HIV and SRH services can prevent risky behaviors that result in HIV infection and adverse reproductive health outcomes [3]

Summary

Introduction

This paper reports changes in behavioral outcomes related to the use of HIV testing service of a project that employed peer-based education strategies and integration of HIV voluntary counseling and testing (VCT) and Sexual and Reproductive Health (SRH) services targeting young people aged 15–24 across 5 provinces in Vietnam. Worldwide, has documented that integration of HIV testing into SRH services can produce beneficial effects on a number of HIV-related health and behavioral outcomes: reducing HIV and sexually transmitted infections (STIs) incidence, increasing use of condoms and contraceptives, improving coverage and uptake of HIV services including HIV testing, enhancing service quality, and strengthening knowledge of HIV and STIs. Research, worldwide, has documented that integration of HIV testing into SRH services can produce beneficial effects on a number of HIV-related health and behavioral outcomes: reducing HIV and sexually transmitted infections (STIs) incidence, increasing use of condoms and contraceptives, improving coverage and uptake of HIV services including HIV testing, enhancing service quality, and strengthening knowledge of HIV and STIs Because it reduces the stigma and discrimination associated with attending HIV voluntary counseling and testing (VCT) exclusive services, the integration of services has promoted access to, and uptake of HIV testing (3–5). Service integration removes redundancies in vertical programs and is able to meet clients’ multiple needs, optimizing program effectiveness and efficiency, especially in resource poor settings [4]

Methods

Results

Discussion

Conclusion