AEGiS-14IAC: Voluntary counselling and testing in South Africa: challenges and opportunities.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Voluntary counselling and testing in South Africa: challenges and opportunities.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrD1020)

Dyk AC
University of South Africa, Pretoria, South Africa

BACKGROUND: VCT is in its infancy in South Africa and is mainly used for diagnostic purposes. The aim of this study is to determine the needs, attitudes and beliefs towards VCT to assist in the implementation of comprehensive VCT services.

METHODS: 1422 participants - 38% male and 62% female with a mean age of 32.5 years (SD=10.2) - gave their views on VCT, in terms of testing, disclosure, behaviour change and counselling. A semi-structured questionnaire was used, and data were analysed with Chi-square and content analysis.

RESULTS: Although subjects generally believed that every person should know his/her HIV status, 17% Black and 5% White subjects were not prepared to go for VCT, because their treatment options were limited and they feared that knowledge of their HIV+ status may lead to "depression, worry, early death and rejection by others". 33% (40% Black and 19% White) subjects preferred to go to an unknown clinic for VCT - 50% because they "do not trust health care workers to keep a secret", 30% preferred "total confidentiality", and 13% "fear prejudice and rejection". 85% preferred rapid testing. 22% would go for VCT without their partners; 80% would disclose to partners, while 16% (mostly men) would keep their HIV+ results a total secret. 77% subjects were willing to change their sexual behaviour if tested positive. A disturbing finding was that 79% of previously tested subjects, did not receive pre-and post-test counselling. Counselling was generally experienced as positive, and subjects expected counsellors to be empathetic, discreet, non-judgmental, supportive, and directive. Discussion: In SA there is a real need for anonymous rapid VCT sites, with referral for ongoing counselling. Emphasis in VCT should be placed on social and behavioural interventions, emotional and coping support, dissemination of information, healthcare, prophylaxis, treatment of opportunistic infections, and assistance in partner notification and future care of children.

Keywords: AEGIS, Counseling, Sex Behavior, HIV Infections, Research Design, HIV Seropositivity, Questionnaires, Confidentiality, Data Collection, Prejudice, South Africa, Human, Male, Child, Female

020707
MoOrD1020