Acceptability and challenges of implementing voluntary counselling and testing (VCT) in rural Zimbabwe

Evidence from the Regai Dzive Shiri Project

Bibliographic Data

ID19441571
AuthorsPetronella Chirawu (0000-0002-4292-2658, University of Zimbabwe, corresponding author), L Langhaug (0000-0002-9131-8158, b Royal Free and University College Medical School , London , UK), Webster Mavhu (0000-0003-1881-4398, University of Zimbabwe), Pascoe (0000-0002-2647-8593, c London School of Hygiene & Tropical Medicine , London , UK), Sophie Pascoe (0000-0002-9199-8333, London School of Hygiene & Tropical Medicine), Jeffrey Dirawo (University of Zimbabwe), Frances M Cowan (0000-0003-3087-4422, The Royal Free Hospital), Frances Cowan (University of Zimbabwe)
Year2010
Volume22
Issue1
Pages81-88
Publication date2010-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540120903012577
PMID20390484
OpenAlexW2077200852
LanguageEN
Citations received17
References cited27

Voluntary counselling and testing (VCT) is an important component of HIV prevention and care. Little research exists on its acceptability and feasibility in rural settings. This paper examines the acceptability and feasibility of providing VCT using data from two sub-studies: (1) client-initiated VCT provided in rural health centres (RHCs) and (2) researcher-initiated VCT provided in a non-clinic community setting. Nurses provided client-initiated VCT in 39 RHCs in three Zimbabwean provinces (2004-2007). Demographic data and HIV status were collected. Qualitative data were also collected to assess rural communities' impressions of services. In a second study in 2007, VCT was offered to participants in a population-based HIV prevalence survey. Quantitative data from clinic-based VCT show that of 3585 clients aged > or =18, 79.4% (95% CI: 78.0-80.7%) were female; young people (aged 18-24) comprised 21.1%. Overall, 32.9% (95% CI: 31.4-34.5%) tested HIV positive. Young people were less likely to be HIV positive 13.5% (95% CI: 11.1-16.1%) vs. 38.1% (95% CI: 36.3-39.9%). In the second study conducted in a non-clinic setting, 27.0% (n=1368/5052) of participants opted to test. Young people were as likely to test as adults (27.3% vs. 26.9%) and an equal proportion of men and women tested. Overall during the second survey, 18.8% (95% CI: 16.7-21.0%) of participants tested positive (youth = 8.4% (95% CI: 6.4-10.7%); adults = 29.1% (95% CI: 25.7-32.7%)). Qualitative data, unique to clinics only, suggested that adults identify RHCs as acceptable VCT sites, whereas young people expressed reservations around these venues. Males reported considering VCT only after becoming ill. While VCT offered through RHCs is acceptable to women, it seems that men and youth are less comfortable with this venue. When VCT was offered in a non-clinic setting, numbers of men and women testing were similar. These data suggest that it may be possible to improve testing uptake in rural communities using non-clinic settings

Environmental health · Family medicine · Health facility · Health services · Population · Turnover · Voluntary counseling and testing · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Homelessness and Social Issues · Medicine · Gerontology