AEGiS-15IAC: The effect of introducing antiretroviral therapy in the public setting on utilization of voluntary counseling and testing (VCT) services in Botswana

AEGiS-15IAC: The effect of introducing antiretroviral therapy in the public setting on utilization of voluntary counseling and testing (VCT) services in Botswana - 2001-2003.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The effect of introducing antiretroviral therapy in the public setting on utilization of voluntary counseling and testing (VCT) services in Botswana - 2001-2003.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1035)

Alwano MG, Roels TH, Mokomane M, Mwasalla V, Molosiwa R, Kilmarx PH
BOTUSA Project, Gaborone, Botswana

BACKGROUND: Free, anonymous, same-day VCT services have been provided in freestanding centers in Botswana beginning in 2000 and with the last of the 16 centers opening in early 2003. In 2002, the government of Botswana began providing antiretroviral therapy (ARV) to selected HIV-infected patients in 4 sites with more than 10,000 people on ARV by the end of 2003. The introduction of ARV was viewed as a major incentive for people to get tested for HIV.

METHODS: HIV positive clients at the VCT centers were referred to the satellite clinics for evaluation using a referral form. Patients were referred to the national and district referral hospitals after being evaluated for ARV at the satellite clinics.

RESULTS: As more centers opened, utilization of VCT services increased dramatically from 9,761 first time testers seen in 2001, to 19,358 in 2002, and 23,617 in 2003. Notably, there has been a substantial increase in number of symptomatic clients seeking VCT, from 39% in 2001 prior to ARV to 53.8% in 2002 and 58.3% in 2003. There has also been a substantial increase in HIV prevalence among first-time VCT clients from 28% in 2001 prior to ARV, to 35.2% in 2002, and 41% in 2003 as many sick clients come to VCT centers with the hope of joining the government ARV program. The freestanding VCT centers are not designed for sick patients, there is therefore increasing stress on the counselors who now give many HIV-positive results daily. Conclusion The introduction of ARV in the government sector appears to have boosted the number of HIV-infected symptomatic clients seeking VCT, posing a challenge and stress to VCT counselors.

Keywords: AEGIS, Counseling, HIV, HIV Infections, Research Design, Prevalence, Acquired Immunodeficiency Syndrome, HIV Seropositivity, HIV Seroprevalence, Botswana, Humans, therapy, utilization, prevention & control, organization & administration

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MoOrD1035