Voluntary Counseling And Testing Use Research Articles

ADAPTIVE MANAGEMENT VCT PADA WANITA PEKERJA SEKS DI PUSKESMAS KABUPATEN PEMALANG DALAM SAAT PANDEMI COVID-19

The Covid-19 pandemic has disrupted the voluntary counseling and testing (VCT) program for female sex workers (WPS) as evidenced by a decrease in the use of VCT in FSW. Therefore, the existence of COVID-19 requires adaptation to program sustainability (adaptive management). The purpose of this study was to find out adaptive management VCT in female sex workers at the Pemalang District Health Center in the Covid-19 pandemic situation. This type of qualitative research uses the focus group discussion (FGD) method to collect data related to the adaptive VCT on female sex workers at the primary health care in the Covid-19 pandemic situation. Participants involved in the FGDs were stakeholders in the management of the VCT HIV program for female sex workers. Data analysis using content analysis method (content analysis). The results showed that the adaptive carried out is not doing mobile VCT, VCT at the primary health care with health protocols, delivering test results via SMS, not doing post-test counseling. Challenges and obstacles in adapting to VCT at the primary health care are the interest of women sex workers to do VCT at the primary health care still low, the counseling provided is limited, women sex workers do not understand the test results, and the risk of messages being not opened. Design improvements based on ideas and ideas are through health promotion with social media, some from the community of female sex workers being role models, owners (pimps) requiring regular VCT FSW at the primary health care, running mobile VCT (6 months) with a health protocol, counselors must be able to provide information that is easy to understand, clear and concise, can use the telephone to convey test results.

Analisis Faktor Dalam Pemanfaatan Layanan Voluntery Counseling And Testing (VCT) Pada Pelanggan Wanita Pekerja Seks (WPS) Di Lokalisasi Lorong Indah Kabupaten Pati

Background: The key population groups, female sex worker (FSW) customers, are still low in utilizing voluntary counseling and testing (VCT) services. This study aims to determine the factors that influence FSW customer behavior in utilizing VCT services.Methodology: This study used a cross sectional design. The samples were 95 FSW customers with accidental sampling technique. The instrument of this study used a questionnaire. The analytical methods were univariate analysis and bivariate analysis using Chi Square.Research Results: The results of this study indicate that the majority of respondents aged 36-45 years have education with a senior high school / university level and most work as entrepreneurs. There was a significant relationship between self-fear factor and the use of VCT with a p-value of 0.016 and other people's support factors with the use of VCT services with p-value 0.001. However, there was no significant relationship between the knowledge factor and the use of VCT services with p-value 0.052.Conclusion: There are a significant relationship between the factors of self-fear and the support of others with the use of VCT services.

The role of integrative model of behavioral prediction in voluntary counseling of individuals with sexual high-risk behavior.

BACKGROUND:Voluntary counseling and testing (VCT) is one of the main efforts for the prevention of high-risk sexual behavior, including HIV/acquired immunodeficiency syndrome (AIDS). The aim of this study was to determine cognitive determinants related to voluntary counseling and HIV testing among Iranian adults based on the integrative model of behavioral prediction (IMBP).MATERIALS AND METHODS:This cross-sectional study was conducted in 2018 among Iranian adults with high-risk sexual behaviors, including drug abuse and unprotected sex, in western Iran. A total of 300 adults were randomly selected to participate voluntarily in this study. Participants filled out a self-administered questionnaire, including the background data and IMBP constructs. Data were analyzed by SPSS version 21, using statistical treatments, such as bivariate correlations, Chi-square test, t-test, and logistic regression at a 95% significant level.RESULTS:Almost 73.3% of the participants had a history of VCT. The highest probability of VCT use was in participants who were in high level of VCT skills (odds ratio: 9.635; 95% confidence interval [CI]: 3.255, 28.514]), following environmental constraints (odds ratio: 6.274; 95% CI: 2.166, 18.171). Furthermore, the IMBP constructs accounted for 85% of the variations in the outcome measure of the VCT use intention.CONCLUSIONS:Based on the result, it appears that the design and implementation of educational programs to improve upon skills and environmental constraints toward VCT use among adults with high-risk behaviors could be useful to the promotion of VCT.

Association between Perceived Seriousness, Cues to Action, and Voluntary Counseling and Testing Uptake in Men Who Have Sex with Men in Pematangsiantar, North Sumatera

Background: Utilization of voluntary counseling and testing (VCT) services in male sex with men (MSM) at Tomuan public health center, in Pematangsiantar is still relatively low (34.4%). The low utilization of VCT services in MSM is related to the perception of seriousness and the possibility of taking action. This study aimed to analyze the influences of perceived seriousness and cues to action on the use of VCT in MSM. Subjects and Method: This was a cross sectional study carried out at Tomuan health center in Pematangsiantar, North Sumatera, in 2017. A sample of 61 MSM was selected for this study. The dependent variable was VCT use. The independent variables were perceived seriousness and cues to action. The data were obtained by questionnaire and analyzed by a multiple logistic regression. Results: Utilization of VCT in MSM increased with perceived seriousness (OR= 11.28; 95% CI= 1.24 to 102.89; p=0.032) and cues to action (OR= 11.45; 95% CI= 1.02 to 128.34; p= 0.024). Conclusion: Utilization of VCT in MSM increases with perceived seriousness and cues to action. Keywords: perceived seriousness, VCT utilization Correspondence: Lambok Nita Situmorang. Masters Program in Public Health, Faculty of Public Health, Universitas Sumatera Utara, Jl. Prof. T. Maas, Medan, North Sumatera. Email: nithastmoors@gmail.com. Mobile: 085372537900. Journal of Health Promotion and Behavior 4(2): 121-125 https://doi.org/10.26911/thejhpb.2019.04.02.04

Factors influencing the uptake of voluntary HIV counseling and testing in rural Ethiopia: a cross sectional study.

BackgroundVoluntary counseling and testing (VCT) has been one of the key policy responses to the HIV/AIDS epidemic in Ethiopia. However, the utilization of VCT has been low in the rural areas of the country. Understanding factors influencing the utilization of VCT provides information for the design of context based appropriate strategies that aim to improve utilization. This study examined the effects of socio-demographic and behavioral factors, and health service characteristics on the uptake of VCT among rural adults in Ethiopian.Methods/designThis study was designed as a cross sectional study. Data from 11,919 adults (6278 women aged 15–49 years and 5641 men aged 15–59 years) residing in rural areas of Ethiopia who participated in a national health extension program evaluation were used for this study. The participants were selected from ten administrative regions using stratified multi-stage cluster sampling. Multivariate logistic regression analysis was performed accounting for factors associated with the use of VCT service.ResultsOverall, men (28 %) were relatively more likely to get tested for HIV than women (23.7 %) through VCT. Rural men and women who were young and better educated, who perceived having small risk of HIV infection, who had comprehensive knowledge, no stigmatization attitude and discussed about HIV/AIDS with their partner, and model-family were more likely to undergone VCT. Regional state was also strongly associated with VCT utilization in both men and women. Rural women who belonged to households with higher socio-economic status, non-farming occupation, female-headed household and located near health facility, and who visited health extension workers and participated in community conversation were more likely to use VCT. Among men, agrarian lifestyle was associated with VCT use.ConclusionsUtilization of VCT in the rural communities is low, and socio-economic, behavioral and health service factors influence its utilization. For increasing the utilization of VCT service in rural areas, there is a need to target the less educated, women, poor and farming families with a focus on improving knowledge and reducing HIV/AIDS related stigma. Strategy should include promoting partner and community conversations, accelerating model-family training, and using alternative modes of testing.

P03.25 Perception of high school students on risk for acquiring hiv and utilisation of voluntary counselling and testing (vct) service for hiv in debre-berhan town, ethiopia: a quantitative cross-sectional study

Introduction Human immunodeficiency virus (HIV) epidemic among youth is largely ignored and remains invisible to both young people themselves and to the society as a whole. Thus, the aim of the study was to assess the extent of perception risk of HIV and utilisation of voluntary counselling and testing (VCT) service among high school students at Debre-berhan Town, Amhara Regional State, Ethiopia. Methods A cross-sectional study was carried out from November 2010 up to January 2011 among secondary school students at Debre-berhan Town. Perception risk and VCT use were considered as dependant variables. A stratified random sampling technique was used to recruit study participants by taking schools as strata. Semi-structured self-administered questionnaire was used to collect the necessary data. Data were entered and analysed using SPSS version 17.0. P-value Results A cross-sectional study was carried out from November 2010 up to January 2011 among secondary school students at Debre-berhan Town. Perception risk and VCT use were considered as dependant variables. A stratified random sampling technique was used to recruit study participants by taking schools as strata. Semi-structured self-administered questionnaire was used to collect the necessary data. Data were entered and analysed using SPSS version 17.0. P-value Conclusion Some students were engaged in risky sexual behaviour even though they had heard about HIV/AIDS. The perception of risk for acquisition of HIV infection and utilisation of VCT were low. Thus, education on topic of HIV/AIDS through integrating as part of school curriculum and encouraging the existing health institutions to provide youth-friendly sexual counselling services including VCT for HIV are strongly recommended. Disclosure of interest statement The authors declare that they have no any competing interests.

Perception of high school students on risk for acquiring HIV and utilization of voluntary counseling and testing (VCT) service for HIV in Debre-berhan Town, Ethiopia: a quantitative cross-sectional study.

BackgroundHuman immunodeficiency virus (HIV) epidemic among youth is largely ignored and remains invisible to both young people themselves and to the society as a whole. Thus, the aim of the study was to assess the extent of perception risk of HIV and utilization of voluntary counseling and testing (VCT) service among high school students at Debre-berhan Town, Amhara Regional State, Ethiopia.MethodsA cross-sectional study was carried out from November 2010 up to January 2011 among secondary school students at Debre-berhan Town. Perception risk and VCT use were considered as dependant variables. A stratified random sampling technique was used to recruit study participants by taking schools as strata. Semi-structured self-administered questionnaire was used to collect the necessary data. Data was entered and analyzed using SPSS version 17.0. P-value < 0.05 was considered as statistically significant.ResultsA total of 339 students were consented to participate in the study and the response rate was 96.3%. The student ages’ were ranged from 15 up to 24 years. Among the study participants, 30 (8.8%) had sexual contact and the mean age of first sexual encounter was 16.4 (SD =2.05) years. Of sexually active students, 12 (40%) had sex with different persons within the last 6 months, 13 (43.3%) had ever used condom and 15 (50%) had used VCT service. There was no statistically significant association between risk perception towards HIV infection and ever use of VCT service (AOR (95% CI) = 1.0(0.30, 4.02).ConclusionsSome students were engaged in risky sexual behavior even though they had heard about HIV/AIDS. The perception of risk for acquisition of HIV infection and utilization of VCT were low. Thus, education on topic of HIV/AIDS through integrating as part of school curriculum and encouraging the existing health institutions to provide youth-friendly sexual counseling services including VCT for HIV are strongly recommended.

The impact of voluntary counselling and testing services on sexual behaviour change and HIV incidence: observations from a cohort study in rural Tanzania

BackgroundIt is widely assumed that voluntary counselling and testing (VCT) services contribute to HIV prevention by motivating clients to reduce sexual risk-taking. However, findings from sub-Saharan Africa have been mixed, particularly among HIV-negative persons. We explored associations between VCT use and changes in sexual risk behaviours and HIV incidence using data from a community HIV cohort study in northwest Tanzania.MethodsData on VCT use, sexual behaviour and HIV status were available from three HIV serological surveillance rounds undertaken in 2003–4 (Sero4), 2006–7 (Sero5) and 2010 (Sero6). We used multinomial logistic regression to assess changes in sexual risk behaviours between rounds, and Poisson regression to estimate HIV incidence.ResultsThe analyses included 3,613 participants attending Sero4 and Sero5 (3,474 HIV-negative and 139 HIV-positive at earlier round) and 2,998 attending Sero5 and Sero6 (2,858 HIV-negative and 140 HIV-positive at earlier round). Among HIV-negative individuals VCT use was associated with reductions in the number of sexual partners in the last year (aRR Seros 4–5: 1.42, 95% CI 1.07-1.88; aRR Seros 5–6: 1.68, 95% CI 1.25-2.26) and in the likelihood of having a non-cohabiting partner in the last year (aRR Seros 4–5: 1.57, 95% CI 1.10-2.25; aRR Seros 5–6: 1.48, 95% CI 1.07-2.04) or a high-risk partner in the last year (aRR Seros 5–6 1.57, 95% CI 1.06-2.31). However, VCT was also associated with stopping using condoms with non-cohabiting partners between Seros 4–5 (aRR 4.88, 95% CI 1.39-17.16). There were no statistically significant associations between VCT use and changes in HIV incidence, nor changes in sexual behaviour among HIV-positive individuals, possibly due to small sample sizes.ConclusionsWe found moderate associations between VCT use and reductions in some sexual risk behaviours among HIV-negative participants, but no impacts among HIV-positive individuals in the context of low overall VCT uptake. Furthermore, there were no significant changes in HIV incidence associated with VCT use, although declining background incidence and small sample sizes may have prevented us from detecting this. The impact of VCT services will ultimately depend upon rates of uptake, with further research required to better understand processes of behaviour change following VCT use.

Community stigma endorsement and voluntary counseling and testing behavior and attitudes among female heads of household in Zambézia Province, Mozambique

BackgroundSome aspects of HIV-related stigma have been shown to be a barrier to HIV services uptake and adherence to antiretroviral treatment (ART). Distinguishing which domains of stigma impact HIV services uptake can enhance the efficacy and efficiency of stigma-reduction interventions.MethodsThe relationships between use of voluntary counseling and testing (VCT) services and two domains of community stigma identified through factor analysis, negative labeling/devaluation and social exclusion, were investigated among 3749 female heads of household. Data were from a general household survey conducted in rural Mozambique. Multivariable logistic regression outcomes were: lifetime VCT use, past-6-months VCT use and VCT endorsement.ResultsThirteen percent (13%) of the participants reported lifetime VCT use, 10% reported past-6-months VCT use and 63% endorsed VCT. A 25-point decrease (from 50 to 25) in the score for negative labeling and devaluation stigma was associated with increased lifetime VCT use (adjusted OR: 1.6, 95% CI: 1.1-2.3) and past-6-months VCT use (adjusted OR: 1.6, 95% CI: 1.1-2.4). A decrease from 50 to 25-points in the score for social exclusion stigma was associated with 1.5 and 1.3-fold increase in odds for past-6-months VCT use and endorsing VCT use, respectively (p < 0.001 for both). Compared with never-testers, considerably high endorsement of VCT use was observed among testers who did not receive HIV test results (adjusted OR: 2.7, 95% CI: 1.6-4.6) and much higher among testers who received results (adjusted OR: 7.3, 95% CI: 4.9-11.0). Distance from health facilities was associated with lower VCT use, but not lower endorsement of VCT.ConclusionsVCT use and endorsement might differ by domains of stigma held by individuals in the community. Greater uptake and favorable disposition towards use of VCT services in rural settings might be achieved by addressing stigma via domain-specific interventions and by improving the proximity of services and the dissemination of HIV test results.

Do accurate HIV and antiretroviral therapy knowledge, and previous testing experiences increase the uptake of HIV voluntary counselling and testing? Results from a cohort study in rural Tanzania

BackgroundDespite the introduction of free antiretroviral therapy (ART), the use of voluntary counselling and testing (VCT) services remains persistently low in many African countries. This study investigates how prior experience of HIV and VCT, and knowledge about HIV and ART influence VCT use in rural Tanzania.MethodsIn 2006–7, VCT was offered to study participants during the fifth survey round of an HIV community cohort study that includes HIV testing for research purposes without results disclosure, and a questionnaire covering knowledge, attitudes and practices around HIV infection and HIV services. Categorical variables were created for HIV knowledge and ART knowledge, with “good” HIV and ART knowledge defined as correctly answering at least 4/6 and 5/7 questions about HIV and ART respectively. Experience of HIV was defined as knowing people living with HIV, or having died from AIDS. Logistic regression methods were used to assess how HIV and ART knowledge, and prior experiences of HIV and VCT were associated with VCT uptake, with adjustment for HIV status and socio-demographic confounders.Results2,695/3,886 (69%) men and 2,708/5,575 women (49%) had “good” HIV knowledge, while 613/3,886 (16%) men and 585/5575 (10%) women had “good” ART knowledge. Misconceptions about HIV transmission were common, including through kissing (55% of women, 43% of men), or mosquito bites (42% of women, 34% of men).19% of men and 16% of women used VCT during the survey. After controlling for HIV status and socio-demographic factors, the odds of VCT use were lower among those with poor HIV knowledge (aOR = 0.5; p = 0.01 for men and aOR = 0.6; p < 0.01 for women) and poor ART knowledge (aOR = 0.8; p = 0.06 for men, aOR = 0.8; p < 0.01 for women), and higher among those with HIV experience (aOR = 1.3 for men and aOR = 1.6 for women, p < 0.01) and positive prior VCT experience (aOR = 2.0 for all men and aOR = 2.0 for HIV-negative women only, p < 0.001).ConclusionsTwo years after the introduction of free ART in this setting, misconceptions regarding HIV transmission remain rife and knowledge regarding treatment is worryingly poor, especially among women and HIV-positive people. Further HIV-related information, education and communication activities are urgently needed to improve VCT uptake in rural Tanzania.

Determinants of Previous HIV Testing and Knowledge of Partner’s HIV Status Among Men Attending a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

Voluntary Counseling and Testing (VCT) remains low among men in sub-Saharan Africa. The factors associated with previous HIV testing and knowledge of partner's HIV status are described for 9,107 men who visited the Muhimbili University College of Health Sciences' VCT site in Dar es Salaam, Tanzania, between 1997 and 2008. Data are from intake forms administered to clients seeking VCT services. Most of the men (64.5%) had not previously been tested and 75% were unaware of their partner's HIV status. Multivariate logistic regression revealed that age, education, condom use, and knowledge of partner's HIV status were significant predictors of previous HIV testing. Education, number of sexual partners, and condom use were also associated with knowledge of partner's HIV status. The low rate of VCT use among men underscores the need for more intensive initiatives to target men and remove the barriers that prevent HIV disclosure.

The Experiences of HIV-Positive Women Living in an African Village

Kenya has approximately 1.4 million adults infected with HIV/AIDS, with a national prevalence rate of approximately 7.4%. The majority of the Kenyan people have not participated in a Voluntary Counseling and Testing (VCT) program and do not know their HIV status. This increases the likelihood of infecting others and spreading the disease. The Living in fear, making the decision to be tested, the journey toward acceptance, changing behavior, planning for the future, and encouraging others to be tested. VCT programs are crucial in attaining goals related to the prevention and management of AIDS. By exploring these women's experiences and perceptions, issues concerning AIDS and the acceptance and use of VCT may be better understood.

Trends in the uptake of voluntary counselling and testing for HIV in rural Tanzania in the context of the scale up of antiretroviral therapy

ObjectivesTo describe trends in voluntary counselling and testing (VCT) use and to assess whether high-risk and infected individuals are receiving counselling and learning their HIV status in rural Tanzania.MethodsDuring two rounds of linked serological surveys (2003–2004 and 2006–2007) with anonymous HIV testing among adults, VCT was offered to all participants. The crude and adjusted odds ratios for completing VCT in each survey were calculated to compare uptake by demographic, behavioural and clinical characteristics, stratified by sex. Repeat testing patterns were also investigated.ResultsThe proportion of participants completing VCT increased from 10% in 2003–2004 to 17% in 2006–2007, and among HIV-infected persons from 14% to 25%. A higher proportion of men than women completed VCT in both rounds, but the difference declined over time. Socio-demographic and behavioural factors associated with VCT completion were similar across rounds, including higher adjusted odds of VCT with increasing numbers of sexual partners in the past 12 months. The proportion having ever-completed VCT reached 26% among 2006–2007 attendees, with repeat testing rates highest among those aged 35–44 years. Among 3923 participants attending both rounds, VCT completion in 2006–2007 was 17% among 3702 who were HIV negative in both rounds, 19% among 124 who were HIV infected in both rounds and 22% among 96 who seroconverted between rounds.ConclusionVCT services are attracting HIV-infected and high-risk individuals. However, 2 years after the introduction of antiretroviral therapy, the overall uptake remains low. Intensive mobilisation efforts are needed to achieve regular and universal VCT use.

Factors Influencing Utilization of Voluntary Counseling and Testing Service in Kasenyi Fishing Community in Uganda

This article reports on part of a study that described models of voluntary counseling and testing (VCT) service delivery and analyzed how a model influenced uptake of VCT services in a Ugandan community. A quantitative, exploratory, and descriptive design was used. Respondents (N = 127, 52% male, 48% female) provided data during structured interviews. Although knowledge about HIV transmission and prevention was high, only 47.2% of respondents had been tested for HIV. Married people were less likely to have been tested than unmarried people. The most common reasons for testing included risky lifestyle, signs and symptoms related to HIV, sex partners' risky lifestyles, and a sex partner's death. The most common barriers to testing were fear of results, belief that it was not necessary, and lack of time. VCT use was low. Sensitization to testing, mobilization of the community, and improving the quality and volume of VCT services are needed.

Barriers and attitudes towards HIV Voluntary Counselling and Testing (VCT) among Secondary School Pupils of Sengerema in Mwanza

OBJECTIVE: To determine barriers and attitudes towards voluntary counseling and HIV-testing among secondary school students in Sengerema district. METHODOLOGY: A cross-sectional study was done in Sengerema district, Mwanza August 2006. A total of 400 secondary school students from the two schools Sengerema district, Mwanza from August to September 2006 were included in the study. By using simple random sampling technique, two secondary schools (Sima and Tuitange) were selected and enrolled in the study. After a verbal consent from each interviewee as well as observing confidentiality to the information data was collected using a pre tested Swahili questionnaire. Data analysis was done using EPI INFO 2002. RESULTS: A total of 400 students from the two secondary schools were interviewed. Out of the 400 students 54% were females. The majority (95.8%) of these students knew that VCT is necessary and a large number (33.8%) of them gave a reason to get HIV education as a reason for HIV services. Only a small number (4.2%) of the students thought that VCT is not necessary with (47.8%) said it to be against the religious teachings. A large proportion (65.8%) of the students knew VCT sites in Sengerema district but only a few (24.3%) of them ever used available VCT services. Of those who ever used VCT services 32.7% were just interested in knowing their HIV status and to get HIV education and only a small number (6.2%) of students used VCT services because they were pressurized by their spouses. For those who never used VCT services (41.8%) said they feared being labeled as HIV positive and 34.9% said these services were not meant for students. It was also observed in this study that VCT services were more accepted among female students than male students. CONCLUSION: From the findings it is concluded that a large number of students knew that VCT use is necessary and the acceptance of VCT among the students is influenced by age where younger students were more willing to use VCT services than older students. The use of VCT services is positively correlated with the level of education and that though a large number of students knew that VCT services are necessary only a small number of students use VCT services. It is recommended that much more effort should be emphasized on encouraging young people to use VCT services.

Perception, attitude and practice of voluntary counseling and testing for HIV/AIDS among undergraduates in a Nigerian University

Background: According to 2006 AIDS epidemic update global summary, the total number of people living with HIV/AIDS world wide is about 39.5 million (34.1-47.7million).1 In Nigeria about 2.9 million (1.7-4.2 million) people were living with HIV/AIDS in 2005.2 The AIDS epidemic continues to spread rapidly among the youth. Objectives: To ascertain the perception attitude and practice of voluntary counseling and testing (VCT) for human immune deficiency virus among undergraduates in a Nigerian Tertiary Institution. Methodology: A cross sectional descriptive survey was carried out among 185 undergraduates of the University of Nigeria Enugu Campus using a self administered questionnaire. A total of 200 questionnaires were distributed, fifteen were not returned hence 185 undergraduates were included in the study. Result: The result is from the study carried out in January 2009. Mean age is 22 + 3.7 SD, 104 (56.3%) males and 80 (43.2%) females. Most 171 (92.4%) were aware of VCT, 177 (95.7%) felt that VCT was important. Inspite of this however a small proportion 48 (25.9%) of the respondents attended VCT services. Most of the respondents gave their reason for non use of VCT as having no knowledge of where to obtain the VCT services. Conclusion and Recommendation: The undergraduates were found to have good knowledge of VCT, access VCT services but low use of the services was discovered. It is therefore recommended that intensive health education and awareness campaign be carried out among the undergraduates to increase their uptake of VCT services. Key words: Perception, attitude VCT, Nigerian, undergraduates

Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment

To describe the associations between socio-demographic, behavioural and clinical characteristics and the use of HIV voluntary counselling and testing (VCT) services among residents in a rural ward in Tanzania. Eight thousand nine hundred and seventy participants from a community-based cohort were interviewed, provided blood for research HIV testing, and were offered VCT. Univariate and multivariate logistic regression was used to identify socio-demographic, clinical and behavioural factors associated with VCT use. Although 31% (1246/3980) of men and 24% (1195/4990) of women expressed an interest in the service, only 12% of men and 7% of women subsequently completed VCT. Socio-demographic factors, such as marital status, area of residence, religion and ethnicity influenced VCT completion among males and females in different ways, while self-perceived risk of HIV, prior knowledge of VCT, and sex with a high-risk partner emerged as important predictors of VCT completion among both sexes. Among males only, those infected with HIV for 5 years or less tended to self-select for VCT compared to HIV-negatives (adjusted odds ratio = 1.43; 95% CI: 0.99-2.14). This contributed to a higher proportion of HIV-positive males knowing their status compared to HIV-positive females. In this setting, a disproportionate number of HIV-positive women are failing to learn their status, which has implications for equitable access to onward referral for care and treatment services. Evidence that some high-risk behaviours may prompt VCT use is encouraging, although further interventions are required to improve knowledge about HIV risk and the benefits of VCT. Targeted interventions are also needed to promote VCT uptake among married women and rural residents.

Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa

This analysis uses data from a population-based household survey and a government clinic survey in the Eastern Cape Province of South Africa to examine attitudes towards voluntary counseling and testing (VCT) services, patterns of utilization of VCT services and the relationships between HIV/AIDS-related stigma, VCT service availability and quality and the use of VCT. The household survey data are linked with clinic-level data to assess the impact of expanded VCT services and access to rapid testing on the likelihood of being tested in rural areas and on HIV/AIDS stigma. Our analysis finds that while overall use of VCT services is low, utilization of VCT services is positively associated with age, education, socioeconomic status, proximity to clinics, availability of rapid testing and outreach services and lower levels of HIV/AIDS stigma. Importantly, the effects of stigma appear considerably stronger for females, while men are more heavily influenced by the characteristics of the VCT services themselves.

HIV Voluntary Counseling and Testing Service Preferences in a Rural Malawi Population

Voluntary counseling and testing (VCT) services have become an integral component of HIV prevention efforts in sub-Saharan Africa. This study of a rural Malawi district population examined variation in past and desired use of VCT services among 868 women aged 15 to 34 and 648 men aged 20 to 44 aware of HIV/AIDS. Only 11% of men and 7% of women had been tested, but of those untested, 76% of men and 61% of women desired testing. Ninety percent of respondents willing to know their results preferred to hear them from a test site counselor and on the same day of the test. However, 27% of women wanting to be tested did not want to know their test results, a finding significantly associated with knowing someone affected by AIDS and perceiving oneself at HIV infection risk. Knowledge of the behaviors of HIV prevention, knowing someone with AIDS, knowing the locations of a test site, and perceived risk of HIV infection all had a consistently significant association with past and future VCT use for men and women.