Abstract
BackgroundVoluntary counselling and testing (VCT) is an important component of national HIV programs, which are necessary to realize the right to health. VCT data also provide valuable information on regional HIV epidemiology.MethodsThe study examines data on the population that obtained HIV VCT in Kenema District, Sierra Leone, from 2004 to 2006, using descriptive statistics and exploring potential HIV risk factors using bivariate and multivariable logistic regression. Analysis was performed separately for two subpopulations: those accessing VCT routinely as part of antenatal care and those specifically seeking VCT.ResultsDuring this period, 2230 people accessed VCT: 1213 through antenatal testing and 1017 specifically seeking VCT. The HIV prevalence was 0.6% in women presenting for antenatal care, 12.6% in women specifically accessing VCT, and 6.7% in men specifically accessing VCT. In both bivariate and multivariable analyses, being female was statistically significantly associated with testing positive in people specifically seeking VCT.ConclusionsThese data from the VCT service in Kenema will be used to improve the accessibility of HIV testing. Questions raised by the analysis will be used to enhance data collection and to inform further research on risk factors.
Highlights
Voluntary counselling and testing (VCT) is an important component of national HIV programs, which are necessary to realize the right to health
The HIV prevalence was 0.6% in women presenting for antenatal care
Much work remains to be done in Sierra Leone to define the epidemiology of HIV and to develop appropriate and accessible services to address the HIV epidemic, both of which are necessary in order for the State to respect, protect, and fulfill the right to health
Summary
Voluntary counselling and testing (VCT) is an important component of national HIV programs, which are necessary to realize the right to health. A national population-based seroprevalence study in 2005 revealed a prevalence of 1.53% [2], with no significant difference in prevalence between women and men. Of those who tested positive for HIV, 91% were HIV-1 positive, 4.5% were HIV-2 positive, and 4.5% were positive for both. The World Health Organization's 2008 update for Sierra Leone indicates that the infection rate for adults aged 15 to 49 was between 1.3% and 2.4% in 2007, as compared with a rate between 0.7% and 2.1% in 2001, with an overall increase in prevalence since 1990 [1]. Further research is clearly needed to define the overall burden of disease and to identify risk factors with greater precision
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