Expanding access to voluntary HIV counselling and testing in sub‐Saharan Africa: alternative approaches for improving uptake, 2001–2007

Abstract

Summary The changing face of the HIV/AIDS epidemic has resulted in new opportunities to increase access to voluntary HIV counselling and testing (VCT), especially during the past 7 years (2001–2007). As access to HIV treatment becomes more widely available in sub‐Saharan Africa, the need for enhanced access to VCT would become even greater. When given the opportunity, many more adults in sub‐Saharan African would accept VCT, and many clearly express the desire to learn their HIV sero‐status. However, in most parts of sub‐Saharan Africa, fewer than one in 10 people know their HIV status. Stigma, fear of receiving an HIV‐positive status, lack of confidentiality, long distances to VCT sites, and long delays in returning HIV test results limit people’s access to traditional VCT systems. Alternative VCT delivery models, such as mobile VCT, routine offer of VCT and home‐based VCT increase access to and uptake of VCT. We recommend that these alternative models be implemented in more settings and on a much larger scale in sub‐Saharan Africa, where VCT uptake rates remain low.

Earlier HIV diagnosis - are mobile services the answer?

“…15 The convenience and accessibility of the mobile service compared with stationary services may account for the difference. 9,10,12 Combining HIV testing with screening for other chronic conditions may reduce stigma, hence encouraging testing in a wider population including males and the elderly.…”

“…In addition, these stationary services may not appeal to most of the population, owing to issues of accessibility, acceptability and confidentiality. [9][10][11][12] Mobile HCT services overcome some of these shortcomings 9 but little is known about the differences between individuals accessing mobile HCT services compared with those tested at health care facilities.…”

Home self-testing for HIV: AIDS exceptionalism gone wrong

“…New or alternative approaches to HIV testing include: (i) models that make subtle changes to the traditional VCT model, such as mobile VCT centres, routine offer of VCT, 24 home-based VCT; 31 The survey encouraged further initiatives to increase uptake of testing.…”

Perceptions and Uptake of Voluntary Counseling and Testing Services among Primary School Teachers in Nakuru County, Kenya: Addressing Containment of HIV/AIDS Pandemic

“…Globally, only about 10% of the infected persons know their HIV status. In the SSA, fewer than one in ten people know their HIV status [18]. In Kenya, the high prevalence rates reported in some regions of the country, including Nakuru County, may be attributed to the fact that most people are unaware of their HIV status [14].…”