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

Department of International Health and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
AIDS Care (Impact Factor: 1.6). 08/2006; 18(5):446-55. DOI: 10.1080/09540120500213511
Source: PubMed

ABSTRACT 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.

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    ABSTRACT: Review question/objective The objective of this review is to determine the effectiveness of home-based HIV counselling and testing in reducing HIV related stigma and risky sexual behavior among adults and adolescents. As a secondary outcome, the review will also determine the effect of home-based HIV counselling and testing on clinical outcomes.
    12/2014; 12:157-169. DOI:10.11124/jbisrir-2014-1903
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    ABSTRACT: Health-facility-based HIV counselling and testing does not capture all children and adolescents who are at risk of HIV infection. Self-testing involves conducting an HIV test at home or in any other convenient space without the involvement of a third party. It is increasingly being argued that it should be incorporated into national HIV-prevention programmes as one of a range of HIV counselling and testing approaches. Although this model of HIV testing is being seen as a new way of reaching under-tested populations, no studies have been conducted on offering it to children. HIV self-tests are now available in South Africa and are sold without the purchaser having to be a certain age. Nevertheless, all HIV testing in children must comply with the norms set out in the Children's Act (2005). Here we explore whether offering self-testing to children would be lawful, by outlining the four legal norms that must be met and applying them to self-HIV testing. We conclude that, although children above the age of 12, years could consent to such a test, there would be two potential obstacles. Firstly, it would have to be shown that using the test is in their best interests. This may be difficult given the potential negative consequences that could flow from testing without support and the availability of other testing services. Secondly, there would need to be a way for children to access pre- and post-test counselling or they would have to be advised that they will have expressly to waive this right. The tests are more likely to be lawful for a small sub set of older children if (i) it assists them with HIV prevention strategies; (ii) they will be able to access, treatment, care and support, even though they have tested outside of a health facility; and (iii) psychosocial support services are made available to them via the internet or cell phones.
    12/2013; 14(4):151. DOI:10.7196/sajhivmed.987
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    01/2015; 5(3):209 - 220. DOI:10.9734/IJTDH/2015/14198


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