AEGiS-15IAC: Predictors of efficiency in HIV voluntary counseling and testing programs: Results from multi-country collaborative research.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Predictors of efficiency in HIV voluntary counseling and testing programs: Results from multi-country collaborative research.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1193)

Marseille E, McConnel CE, Dandona L, Marshall N, Lioznov D, Hansl B, Bautista S, Stanley N, Muyingo S, Krupitsky E, du Plessis J, Zvartau E, Bertozzi S, Gaist P, Kahn JG
Institute for Health Policy Studies, University of California, San Francisco, United States

BACKGROUND: Understanding the correlates of efficiency in operating voluntary counseling and testing (VCT) programs could strengthen the impact of HIV prevention efforts in low and middle-income countries. The purpose of this analysis is to assess the association of key program features with efficiency in the provision of VCT.

METHODS: We compared high and low-efficiency VCT programs in India, Uganda, South Africa, Mexico and Russia during 2002-2003, as part of the PANCEA project. The presence and extent of five potential predictors of efficiency was compared within and between countries. These were scale, use of volunteers, and reported impact of mass media campaigns on caseload, use of rapid tests, and focus on prevention or treatment. Standard costing techniques were used to measure efficiency. The primary outcome measure was the cost per client who completed the VCT sequence.

RESULTS: The cost per client completing the VCT sequence ranged from $3 to $83 in Uganda; $40 to $171 in South Africa; $4 to $13 in India; $6 to $114 in Russia; and $66 to $102 in Mexico. Overall, the high-efficiency sites had 3.2 of the examined correlates versus 1.4 for the low-efficiency sites. The predictors most consistently related to high efficiency were large scale and prevention focus. Less consistent but also favoring efficiency was use of rapid test. Using volunteers and a positive perceived effect of IEC was not related to efficiency. Qualitative data support and explain these findings.

CONCLUSIONS: The efficiency of these VCT programs was found to be associated with the selected program features. Uniform data collection methods allowed a comparative study, which yielded policy-relevant findings.

Keywords: AEGIS, Counseling, Research Design, Research, Acquired Immunodeficiency Syndrome, Voluntary Programs, Uganda, India, South Africa, Mexico, Russia, Humans, prevention & control, organization & administration

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TuOrC1193