HIV incidence during a cluster-randomized trial of two strategies providing voluntary counselling and testing at the workplace, Zimbabwe

Corbett, Elizabeth L.; Makamure, Beauty; Cheung, Yin Bun; Dauya, Ethel; Matambo, Ronnie; Bandason, Tsitsi; Munyati, Shungu; Mason, Peter R.; Butterworth, Anthony E.; Hayes, Richard

doi:10.1097/qad.0b013e3280115402

Cited by 91 publications

(91 citation statements)

References 25 publications

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“…Several HIV and STI incidence studies in Africa have found no population-level impact of VCT (12)(13)(14). Although a critical link to life-prolonging treatment, HIV testing is therefore unlikely to substantially alter the epidemic's course [the potential for domestic violence against women who test positive must also be considered (15)].…”

Section: Hiv Testingmentioning

confidence: 99%

Reassessing HIV Prevention

Potts

Halperin

Kirby

et al. 2008

Science

179

147

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Section: Hiv Testingmentioning

confidence: 99%

Reassessing HIV Prevention

Potts

Halperin

Kirby

et al. 2008

Science

179

147

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“…However, similar effects are not as convincing for the large proportion who test negative. A recent study found increased risk behaviors in HIV negative individuals after undergoing VCT (Sherr et al 2007) while a comparison of two VCT strategies in Zimbabwe found that despite improved acceptability of the trial VCT strategy, risk behaviors continued in individuals testing negative following their diagnosis (Corbett et al 2007). Although there has been a focus on increasing the number of people undergoing HIV testing and counseling, currently less than a quarter of HIV positive individuals in most countries in sub-Saharan Africa are aware of their status (WHO, UNAIDS and UNICEF 2007).…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

et al. 2008

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Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context. Abstract Uptake of VCT remains low in many subSaharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.

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“…Risk compensation will likely be the bane of vaccines against the virus (Blower and McLean, 1994). While voluntary counselling and testing promotes more condom use among those tested positive for HIV, the majority who test negative have been observed to either maintain risky sexual practices or adopt riskier sexual practices (Corbett et al, 2007;Matovu et al, 2007;Sherr et al, 2007;Weinhardt et al, 1999). Circumcised men have also been observed to have riskier sexual practices than uncircumcised men, likely in response to the awareness of decreased susceptibility to HIV (Bailey et al, 1999).…”

Section: Problems With the Risk Reduction Approach Risk Compensation mentioning

confidence: 99%

“…Antiretroviral therapy is logistically untenable and prohibitively expensive within developing economies, valued at 350 (US) dollars per infected person per year (Creese et al, 2002;Dieffenbach and Fauci, 2011;Walker, 2004). Voluntary counselling and testing, valued at 400 to 500 (US) dollars per infection avoided (Creese et al, 2002), is similarly prohibitive, and its implementation has not been demonstrated to reduce viral prevalence within developing settings (Corbett et al, 2007). Male circumcision appears to be the only risk reduction approach that is both effective and universally applicable, owing to its one-time treatment, its existing prevalence in West Africa and among African Muslims, social acceptability, and its continuous effect with every act of intercourse (Anonymous, 2007;Halperin and Epstein, 2007;Potts et al, 2008;Weiss et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Aids Prevention in Sub-Saharan Africa: As Easy as Abc?

Bertrand¹

2015

AJID

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Background: The failure to stem HIV in sub-Saharan Africa and the unique epidemiological modes of infection within this region have demonstrated that unique strategies for combatting the virus are required. This review article discusses why international AIDS campaigns in subSaharan Africa have largely been unsuccessful, and what, if any, strategies have worked. Methods: Articles were compiled using Web of Science and Google Scholar search engines. Results: Inspired by past successes in the West and in Southeast Asia, Western AIDS initiatives have attempted to replicate these results within the African continent through 'risk reduction' approaches, vying to reduce the probability of HIV transmission per coital act via physical or biochemical barriers such as condoms, male circumcision, antiretroviral therapy, post-exposure prophylactic drugs, and treatment of sexually transmitted infections. However, more than three decades of research have demonstrated that the most successful strategies were African-inspired, relied on local resources with minimal Western support, culturally relevant, and used social engineering programs that dismantled networks of sexual relationships by promoting the practice of abstinence, reducing the number of sexual partners, discouraging multiple and concurrent relationships, delaying sexual debut, and maintaining mutually monogamous relationships. Conclusion: Known through the mnemonic 'ABC' (Abstinence, Be faithful, Condoms), this strategy was first implemented in Uganda, yielding remarkable successes both in Uganda and thereafter in other African nations in stemming HIV. AIDS agencies should support and encourage programs that use this culturally sensitive, low cost, and effective strategy.

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HIV incidence during a cluster-randomized trial of two strategies providing voluntary counselling and testing at the workplace, Zimbabwe

Cited by 91 publications

References 25 publications

Reassessing HIV Prevention

Reassessing HIV Prevention

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

Aids Prevention in Sub-Saharan Africa: As Easy as Abc?

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