Repeat Voluntary HIV Counseling and Testing (VCT), Sexual Risk Behavior and HIV Incidence in Rakai, Uganda

Matovu, Joseph K. B.; Gray, Ronald H.; Kiwanuka, Noah; Kigozi, Godfrey; Wâbwire-Mângen, Fred; Nalugoda, Fred; Serwadda, David; Sewankambo, Nelson; Wawer, Maria J.

doi:10.1007/s10461-006-9170-y

Cited by 50 publications

(43 citation statements)

References 25 publications

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“…Given the relatively short period of time VCT has been accessible to Ethiopians, this is a considerable proportion of the client base, comparable to the 38% found in the aforementioned Uganda study [12]. Repeat HIV testing was associated with more reported risk behavior, which is in accordance with findings from other studies.…”

Section: Discussionsupporting

confidence: 88%

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Client Characteristics and HIV Risk Associated with Repeat HIV Testing Among Women in Ethiopia

et al. 2010

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In Ethiopia, the number of HIV tests administered doubled from 2007 to 2008. However, very little is known about the number of clients testing repeatedly in one year, or their motivations for doing so. We examine repeat HIV testing among 2,027 Ethiopian women attending eight VCT facilities in 2008. Multivariate logistic regression was used to examine associations between repeat HIV testing and demographic, behavioral, and psychosocial characteristics, as well as HIV status. Nearly 40% of clients had tested previously for HIV. Women with high sexual risk are nearly four times more likely than those with no sexual risk to have tested previously, but HIV prevalence was lower among repeat testers (6.5%) than first-time testers (8.5%). Moderate perceived vulnerability, or feeling powerless to prevent HIV infection, is associated with a 50% increased likelihood of being a repeat tester. High perceived behavioral risk is associated with a 40% reduction in the likelihood a woman is testing for at least the second time. Costs associated with repeat testing should be balanced against identification of new HIV cases and prevention benefits.

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Section: Discussionsupporting

confidence: 88%

“…Conducted in Rakai, Uganda, this study found 38% repeat testing among acceptors of HIV counseling and testing and higher sexual risk among repeat compared to first-time testers [12].…”

Section: Introductionmentioning

confidence: 80%

Client Characteristics and HIV Risk Associated with Repeat HIV Testing Among Women in Ethiopia

et al. 2010

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“…7 This effect is not so clear in seronegative individuals 8 or in those who have been tested several times. 9 A number of evaluations has been published on the efficacy of interventions to prevent sexual risk behavior and sexually transmitted diseases (STD) in different populations 10 -14 ; however, few studies have evaluated health interventions that focus on reducing risk practices in serodiscordant couples in developed countries, 6,15,16 and practically none of them refer to the era of highly effective antiretroviral treatments (HAART).…”

mentioning

confidence: 99%

Reducing Sexual Risk Behavior Among Steady Heterosexual Serodiscordant Couples in a Testing and Counseling Program

Hernando¹,

Romero²,

Garcı́a³

et al. 2009

Sexually Transmitted Diseases

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“…We have not examined the impact on those that tested HIV negative. A meta-analysis (Weinhardt, Carey, Johnson, & Bickham, 1999) and, more recently, studies from a rural research program in Uganda (Matovu et al, 2005(Matovu et al, , 2007 and from a workplace program in Zimbabwe (Corbett et al, 2007) have cast doubt on the positive effects of VCT on sexual risk behavior among people who are HIV-1 uninfected. Further studies are needed into the impact of VCT on HIV-1 incidence in HIV-negative tested persons (Glick, 2005;Matovu et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Long-term voluntary counseling and testing (VCT) uptake dynamics in a multicountry HIV workplace program in sub-Saharan Africa

et al. 2010

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High uptake of HIV voluntary counseling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards, Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. Between September 2001 and December 2007, 9723 adult beneficiaries were tested for HIV in 14 company sites in five African countries. Three hundred and seventy (3.8%) of tested persons were infected with HIV-1. During the first 12 months 1412 tests were done, compared to 8311 tests in the subsequent years. The annual average uptake of testing among eligible persons varied between 15 and 32%. The coverage was higher among female compared to male employees, and higher among female compared to male spouses. Distinct peaks in uptake were linked to specific local events. HIV-1 infected persons were significantly more likely to be tested in the early period. The proportion of HIV-1 infected persons among testees was 8.8% in the first 12 months compared to 3.0% in the subsequent period (p<0.001). HIV-1 infected persons diagnosed in the early period were in a more advanced clinical stage, and had a significantly lower CD4 count than those tested later (median CD4 count 227 vs. 314 cells/microl; p=0.002). In this workplace program, HIV-1 infected individuals came earlier for an HIV test than uninfected people, and people with advanced infection came earlier than those with less advanced disease. Employees' spouses are harder to reach than employees and extra efforts should be undertaken to reach them as well. Uptake of HIV testing can be actively influenced by educational or promotional activities.

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Repeat Voluntary HIV Counseling and Testing (VCT), Sexual Risk Behavior and HIV Incidence in Rakai, Uganda

Cited by 50 publications

References 25 publications

Client Characteristics and HIV Risk Associated with Repeat HIV Testing Among Women in Ethiopia

Client Characteristics and HIV Risk Associated with Repeat HIV Testing Among Women in Ethiopia

Reducing Sexual Risk Behavior Among Steady Heterosexual Serodiscordant Couples in a Testing and Counseling Program

Long-term voluntary counseling and testing (VCT) uptake dynamics in a multicountry HIV workplace program in sub-Saharan Africa

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