AEGiS-14IAC: Reported and observed HIV counseling by clients seeking Sexually Transmitted Disease (STD), Tuberculosis (TB) and Family Planning (FP) services at various sites in Uganda.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Reported and observed HIV counseling by clients seeking Sexually Transmitted Disease (STD), Tuberculosis (TB) and Family Planning (FP) services at various sites in Uganda.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrD1022)

Kalibala S, Neema S, Waibale P, Kalule J, Rutenberg N, Wangalwa S, Geibel S, Kibombo R, Mulondo N, Lukanika H, Tumuhairwe K, Wanderema S, Mukasa S, Tumuhairwe E
Population Council, Nairobi, Kenya

BACKGROUND: Services for the management of TB, STDs, and FP provide an opportunity to discuss HIV and offer VCT. Efforts have been undertaken in Uganda to offer a comprehensive package of VCT, FP, TB, and STD and care and support services at 4 AIDS Information Centre (AIC) and 9 primary health care (PHC) facilities. Interventions to strengthen the integration of services consisted of training on HIV counseling and integration; supervisory visits; a new clinical form and IEC materials.

METHODS: Exit interviews were administered to 138 FP, TB and STD clients at baseline and to 81 FP, TB, and STD clients after 6 months. To corroborate client reports, 331 and 209 FP, TB and STD service delivery sessions were also observed at baseline and follow-up, respectively.

RESULTS: a) FP clients discussing HIV prevention with the provider rose from 12.7% (n= 71) to 51.9% (n=54) (p=0.000). FP clients reporting HIV pre-test counseling rose from 9.9% to 25.9% (p=.017. b) TB clients reporting discussion of HIV rose from 17.4% (n=46) to 46.2% (n=13) (p=.042). TB clients reporting HIV pre-test counseling rose from 11.1% to 30.8% (p=.012). c) STD clients reporting discussion of HIV rose from 23.8% (n=21) to 42.9% (n=14) (p= .206) Reported HIV pre-test counseling by STD clients rose from 14.3% to 28.6% (p=.270). d) Observations also showed an improvement: FP sessions where HIV needs were assessed increased from 12.7% (n=118) to 28.4% (n= 67) (p=0.001), TB sessions which included an assessment of HIV needs increased from 15.4% (n=123) to 24.1% (n=58) (p=0.013), and STD sessions where HIV needs were assessed rose from 18.9% (n=90) to 26.2% (n=84) (p= 0.171).

CONCLUSIONS: Following the implementation of a simple intervention, the proportion of FP, TB and STD clients who received HIV counseling increased. However, further efforts need to be directed to changing STD provider behavior who serve a population at particularly high risk of HIV transmission.

Keywords: AEGIS, Sexually Transmitted Diseases, Counseling, HIV Infections, Family Planning Services, Tuberculosis, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Ambulatory Care Facilities, Health Services Needs and Demand, Mass Screening, Uganda, Human, organization & administration

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MoOrD1022