16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

THE RAPID EXPANSION OF HIV COUNSELING AND TESTING IN BOTSWANA THROUGH A STRATEGIC MIX OF SERVICE DELIVERY MODELS – LESSONS LEARNED 2000 TO 2004

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. TuAc0103

M.G. Alwano¹, D. Fleming², T.H. Roels², M. Kejelepula³, T. Tomeletso³, R. Molosiwa⁴, P.H. Kilmarx^2
1 BOTUSA Project, Global AIDS Program, Gaborone, Botswana, ² BOTUSA Project / CDC Botswana, Gaborone, Botswana, ³ Ministry of Health, Botswana, Gaborone, Botswana, ⁴ Tebelopele Voluntary Counseling and Testing Centres, Gaborone, Botswana

ISSUES: Botswana has one of the highest HIV prevalence rates in the world with 37.4% among pregnant women aged 15 – 49 years (2003). With the introduction of free antiretroviral therapy (ART) in 2002, it became imperative that counseling and testing (CT) be scaled up to optimize treatment and enhance prevention.

DESCRIPTION: During 2000 – 2003, the BOTUSA Project established a network of 16 freestanding Tebelopele CT centers countrywide. In 2003, mobile caravans were added, thus expanding these CT services to even more remote areas. Between April 2000 and December 2004, the Tebelopele network served 176,805 clients. In January 2004, the Botswana government introduced routine "opt-out, non-compulsory" HIV testing in all government health facilities. During 2004, with less than 50% of the 281 health facilities reporting, 60,846 blood samples were tested, of which 41.8% were HIV positive. In the Botswana AIDS Impact Surveys 2001 and 2004, the proportion of Batswana who knew their status increased from 18.1% to 25.4%.

LESSONS LEARNED: Key factors contributing to the success of both CT models were

Despite setbacks and delays, routine HIV testing at government facilities is now gaining momentum. So far, it has had no negative effect on the demand for HIV testing at the Tebelopele CT centers. Challenges exist for both delivery models: doing CT anonymously and then referring to government clinics (for Tebelopele); assuring adequate supplies of HIV test kits; motivating staff to perform tests; and implementing a comprehensive reporting system (for routine testing).

RECOMMENDATIONS: In high-prevalence settings such as Botswana, client-initiated HIV CT models (Tebelopele) may be implemented side by side with provider-initiated models such as the “opt-out, non-compulsory” HIV testing.

Download PDF of this abstract.

Download Power Point Presentation.

2006-08-13
TuAc0103

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.