AEGiS-15IAC: The effect of introducing hospital-based antiretroviral therapy (ART) on freestanding voluntary counseling and testing (VCT) centers in the community.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The effect of introducing hospital-based antiretroviral therapy (ART) on freestanding voluntary counseling and testing (VCT) centers in the community.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1318)

Haidula M, Holland S, Kenyon TA, Musheko D, van der Veen F, Bussell K
Social Marketing Association, Windhoek, Namibia

BACKGROUND: The Social Marketing Association of Namibia opened 3 freestanding VCT centers in Windhoek and Oshakati in February 2003. The Government of Namibia announced plans to introduce ART in nearby government hospitals in May 2003. We evaluated the effect that the announcement had on clientele at the centers.

METHODS: A client intake sheet is completed on each client and entered into a computer database. We compared demographics, socioeconomic characteristics, risk factors, and referral patterns before and after the introduction of ART.

RESULTS: A total of 3,420 clients received VCT from February-November, 2003, including 851 (243 per month) before, and 2569 (342 per month) after the announcement. Of these, 57.1% were female, median age was 29 years, 85% completed at least secondary education, 43% were employed, 51% had tested before, and 14% were HIV-positive. Compared with before the announcement, clients afterwards were more likely to be HIV-positive (15% vs 11%, P=0.02), and symptomatic if HIV-positive (24% vs 15%), especially if male (30% vs 7%, P=0.008) compared with females (21% vs 18%, P=0.6). The proportion of female clients who were pregnant increased from 2.4% to 4.5%, which was not statistically significant. The proportion of HIV-positive clients referred for ART evaluation increased from 5% to 32% (P<0.001) and to public health facilities from 24% to 47% (P<0.001) before and after the announcement, respectively. Conclusion The announcement was associated with a 41% increase in VCT clients, an influx of symptomatic clients who had not previously known they were HIV-positive, especially males, and with more clients being referred to public facilities for evaluation. ART availability provides an important incentive to people to want to know their HIV status. Non-governmental freestanding VCT centers are important partners with governmental health facilities providing ART services.

Keywords: AEGIS, Counseling, Research Design, HIV Seropositivity, Hospitals, Demography, Risk Factors, Prevalence, Namibia, Humans, Female, Male, Pregnancy, therapy, prevention & control, organization & administration

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