Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

602 Abstracts ThPeF8053-ThPeF8057

XIV International AIDS Conference

Recommendations: While VCT must be maintained and promoted in the settings for which it was developed, diverse streamlined approaches to helping people know if they are infected must be explored.
Presenting author: Kevin O'Reilly, Department of HIV/AIDS, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
ThPeF8053 Strategies for effective implementation of services
of Voluntary Counseling and Testing Center (VCTC)
in developing countries like India for meeting the
challenges of the HIV epidemic
S.S. Joshi, A. Gogate, A. Bamne, S.H. Joshi. Mumbai Districts AIDS Control
Society (MDACS), Mumbai, India
Issues: Voluntary Counseling & Testing (VCT) is a vital & effective strategy for
removing unawareness & ignorance about knowing HIV status. As reported, the
VCTCs in Mumbai are not cost-effective. Presently VCTCs in Mumbai viewed as
Diagnostic Centers serve no purpose of VCT satisfactorily. Hence there was urgent need to define strategy for optimum utilization of VCTC reaching the needy
population.
Description: VCT is a door to prevention care & support activities for combating
the HIV epidemic. In 2001, globally 40 million people were living with HIV mostly
unaware of their HIV status. With rise in HIV infections there is a need to make
VCT effectively available to all by identifying specific strategies for the lacunae in
these services. Reports compiled in Mumbai in the year 2001 states 84,531 samples tested of which 14.39% were Voluntary & 85.61% referred for clinically diagnosis having 20.73% & 10.70% HIV seropositivity respectively. These reports give
a clear view of the unsatisfactory utilization & cost-effectiveness of the VCTC in
Mumbai. Therefore, the factors involved in effective implementation of VCT have
been discussed.
Lessons learned: Constant monitoring & evaluation to improve the quality of
Counseling & HIV testing services is the pre-requisite for VCT. Efforts in publicity
& clear messages formed the essence for removal of fear stigma & apprehension
utilizing these services. Mumbai established 19 VCTC however mere creation of
services does not necessarily guarantees its utilization unless other supportive
services are added upon it. Different strategies at different levels of the society
needed to make VCT easily accessible to all.
Recommendations: Specific efforts for utilization of VCTC by appropriate beneficiaries in the form of tailor-made information high quality counseling services
strict adherence to confidentiality yields better results. The specialized training of
counselors & services with dignity to client forms the backbone of this utility.
Presenting author: Sudhakar Joshi, G-303, Balajikrupa C.H.S., Sector 28,
Nerul (W), Navi- Mumbai-400 706, India, Tel.: [phone], Fax: [phone], E-mail: sudhakarj71 @ rediffmail.com
ThPeF8054 VCT effectivity in HIV/AIDS prevention
M.M. Bauni, C.L. Aluoch, N.O. Onyango, L.O. Odiembo. TAPWAK, Po. box
30583, 00100, Nairobi, Kenya
Description: In Ugunja, TAPWAK clinic established in a poor neighborhood and
offered VCT services to individuals and couples. The participants received pretest counseling, HIV testing as well as post-test counseling. Follow up visits offered a behavioral survey and STD diagnosis and treatment. Over 5,00 individuals
and 100 couples took part in the trials.
Results: The researchers found that VCT for HIV-1 reduces unprotected intercourse among individuals and couples. Reduction of unprotected intercourse was
significantly greater among those who tested positive for HIV-1. Seventy percent
of the individuals and 91 percent of the couples who participated in the trial, revealed their status to their sexual partners. These high rates of disclosure were
attributed to the type of counseling provided by VCT. For more details:
Conclusion: HIV/AIDS voluntary counseling and testing (VCT) is a highly costeffective prevention strategy in developing countries, a recent study found. VCT
provides individuals and couples with knowledge of their status and empowers
them to seek care and support. Even when advanced HIV/AIDS treatment is not
easily available, individuals can receive assistance in developing risk reduction
plans based on their HIV status and sexual relationships.
Presenting author: Mercy Mumbi Bauni, Ro. box 30583, 00100, Nairobi, Kenya,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8055 Expanding access to and demand for quality VCT
services in Zambia using an integrated community
centred approach
D.C. Siame1, C. McLanachan2, K. Shelley3. 'International HIV/AIDS Alliance

Zambia, International HIV/AIDS Alliance Zambia, PO Box 33796, Lusaka,
Zambia; 2International HIV/AIDS Alliance, Brighton, United Kingdom;
3 USAID/Zambia, Lusaka, Zambia
Issues: Zambia national HIV prevalance rate is 20% but only 6% of Zambians
have had an HIV test & know the result. VCT is recognised as a key entry point
for HIV/AIDS prevention, care and support.
Description: The 'Zambia VCT Partnership' (govt. donors, NGOs) was formed in

2001 to support the expansion of VCT services in Zambia. Collectively the partners aim to increase access to and demand for quality VCT services using an
integrated model. The components include test site facilities, counsellor training,
community mobilisation, IEC and post test support. NGOs & CBOs are supported
to integrate VCT into existing community level prevention and care work and to
strengthen referral network.
Lessons Learned:
- It is important to place VCT within the broader context of prevention & care
services.
- Community mobilisation on VCT is particularly important as it increases community understanding, demand for testing, reduces stigma & sensitises the community to broader HIV/AIDS issues.
- PLHA involvement is a key strategy for effective community mobilisation, quality
post test services and stigma reduction.
- Co-ordinated partnership at national and district levels helps to deliver a comprehensive VCT service.
Recommendations: - This approach to the expansion of VCT should be scaled
up in Zambia and be a model programme for others to learn from, adapt and
replicate.
Presenting author: Daphetone C. Siame, International HIV/AIDS Alliance Zambia, PO Box 33796, Lusaka, Zambia, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeF8056 Voluntary counseling and testing services in Ghana
N.I. Nii-Trebil, W.K. Ampofo, S. Aidoo, F. Yankey2, S.V. Nuvorl, E. Obeng2,
M. Atakorah2, J. Nerquaye-Tetteh2, K. Ishikawa3, D. Ofori-Adjei1. 'Noguchi
Memorial Institute for Medical Research, University of Ghana, Legon, Noguchi
Memorial Institute for Medical Research, University of Ghana, F 0. Box LG 581,
Legon-Accra, Ghana, Ghana; 2Planned Parenthood Association of Ghana
(PPAG), Accra, Ghana; 3AIDS Research Center, National Institute of Infectious
Diseases (NIID), Tokyo, Japan
Issues: HIV voluntary counselling and testing (VCT) has long been a component
of HIV prevention and care efforts in developed countries. Despite its recognized
importance in national AIDS control programs, HIV VCT are not fully developed
in resource-constrained countries like Ghana. As part of efforts to strengthen and
expand HIV VCT services in Ghana, the NMIMR, with grant assistance from the
Embassy of Japan, conducted a HIV/AIDS/STDs Health Awareness Project in
some rural communities of the Eastern Region of Ghana. The objectives were
to educate the people on HIV/AIDS/STDs and to offer HIV VCT and general
health services. The aim was to assist them to initiate and maintain preventive
behaviours and help combat stigma and discrimination.
Description: Ten selected communities were visited and offered health-oriented
services including HIV VCT Rallies were held, during which talks were given and
films were shown on HIV/AIDS/STDs. At the following day's clinic session, pre-test
counseling, testing for HIV and post-test counselling were offered to volunteers.
Tests on urine and some biochemical parameters of blood were also done. Referrals to appropriate support services were made when necessary. A well-equipped
laboratory van, a generator and well-trained personnel aided the work.
Lessons learned: On average, 6,621 adults and children/youth attended the rallies during each round of visits to the communities. A total of 838 people voluntarily took the HIV test (12.5% of total adult population of 6,686). All those who
tested returned to receive their test results. Out of the number, 18 (2.1%) of them
(4 males and 14 females) were confirmed positive. Urine and blood biochemical
test results were mostly normal. Condom sales increase by 143% in within four
(4) months after the VCT exercise begun in July 2001.
Recommendations: The VCT service needs to be monitored through follow-up
and also extended to other communities in Ghana
Presenting author: Nicholas Nii-Trebi, Noguchi Memorial Institute for Medical
Research, University of Ghana, P O. Box LG 581, Legon-Accra, Ghana, Ghana,
Tel.: [phone], 500374, Fax: [phone], E-mail: [email protected]
ThPeF8057 Randomized trial comparing return rates for hiv
test results using home-collection test kits and
clinic-based testing
R. Wickrema, R. Scotti, H. Navaline, H. Mark, D. Fiore, A. Davis-Vogel,
D. Metzger. university of pennsylvania, 3535 market street, 4th floor,
philadelphia, pa 19104, United States
Background: The clinic-based voluntary HIV testing and counseling (VCT) program in the United States suffers high rates of failure-to-return for results; as high
as 50 percent in many states.
Method: In this randomized trial we compare test- completion rates by mode
of testing among 489 high-risk drug users drawn from methadone maintenance,
detoxification, and syringe exchange programs in Philadelphia. Those eligible and

consented were randomly assigned to: 1) home-collection kits (HCTK) and clinicbased traditional counseling and testing (TCT). Groups were compared on their
reported rates of receiving results.
Results: At the two-month follow-up visit more people in the HCTK group reported obtaining test results n= 137 compared to the TCT group, n=111; (57.1%
vs. 44.6%; Chi Square = 7.65 p< 0.01). Multiple logistic regression analyses were
used to examine factors associated with receipt of results. Controlling for demo