Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
Rapid HIV testing and counseling for voluntary testing centers in Africa.
AIDS. 1997 Sep;11 Suppl 1:S103-10. Unique Identifier : AIDSLINE /MED98025856 McKenna SL; Muyinda GK; Roth D; Mwali M; Ng'andu N; Myrick A; Luo C; Priddy FH; Hall VM; von Lieven AA; Sabatino JR; Mark K; Allen SA; Project San Francisco, Lusaka, Zambia.
Abstract:
OBJECTIVE: Voluntary HIV testing and counseling (VTC) has been shown to reduce the incidence of HIV in cohabiting couples who now represent the majority of new infections in many African cities. Community and client perceptions of a 1-day voluntary testing and counseling program in Lusaka, Zambia, were assessed, and a rapid HIV-testing algorithm was evaluated for VTC centers. METHODS AND DESIGN: Between May 1995 and June 1996, outreach workers distributed written invitations door to door. The 1-day program was held 6 days/week including weekends. Transport, child care and lunch were provided. Community and client surveys followed in July 1996. RESULTS: Over 3500 couples married for a median of 4-5 years requested testing: 23% were HIV+/+, 57% were HIV-/- and 20% were discordant with one HIV+ and one HIV- partner. Sixty-eight per cent of couples surveyed had made the decision to be tested before attending the 1-day program and 80% had not previously known where to obtain HIV testing. Knowledge that couples could show discordant results rose from 29 before to 88% after pretest counseling. Clients reported high levels of satisfaction with the services and 90 out of 99 (92%) preferred to receive their results the same day. Clients at another center who waited 10 days for their results reported more fear, and 19 out of 31 (61%) would have preferred to get their results the same day. Over 99% of those who attended the program thought active promotion of voluntary HIV testing in the community was a positive thing, as did 90% of those who were invited but did not attend. Sensitivity and specificity of the rapid test algorithm were both 99.4% in this setting. CONCLUSIONS: Active promotion of voluntary HIV testing and counseling in couples is needed to reduce the spread of HIV in high-prevalence areas. The use of rapid, on-site HIV testing allows clients to receive result-specific counseling in a single visit. Ongoing quality control of a subset of samples at an outside laboratory is essential.
Keywords: *Acquired Immunodeficiency Syndrome/PREVENTION & CONTROL *HIV Infections/PREVENTION & CONTROL *HIV-1/ISOLATION & PURIF 980130
M9811055
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Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
