Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa |
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| Authors: | Tonderai Mabuto Mary H Latka Bulelani Kuwane Gavin J Churchyard Salome Charalambous Christopher J Hoffmann |
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| Institution: | 1. The Aurum Institute, Johannesburg, South Africa.; 2. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.; 3. London School of Hygiene and Tropical Medicine, London, United Kingdom.; 4. Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.; Wits Reproductive Health and HIV Institute, South Africa, |
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| Abstract: | BackgroundHIV Counseling and Testing (HCT) is the point-of-entry for pathways of HIV care and prevention. However, HCT is not reaching many who are HIV infected and this may be related to the HCT provision model. We describe HCT utilization and HIV diagnosis using four models of HCT delivery: clinic-based, urban mobile, rural mobile, and stand-alone.MethodsUsing cross-sectional data from routine HCT provided in South Africa, we described client characteristics and HIV test results from information collected during service delivery between January 2009 and June 2012.Results118,358 clients received services at clinic-based units, 18,597; stand-alone, 28,937; urban mobile, 38,840; and rural mobile, 31,984. By unit, clients were similar in terms of median age (range 28–31), but differed in sex distribution, employment status, prior testing, and perceived HIV risk. Urban mobile units had the highest proportion of male clients (52%). Rural mobile units reached the highest proportion of clients with no prior HCT (61%) and reporting no perceived HIV risk (64%). Overall, 10,862 clients (9.3%) tested HIV-positive.ConclusionsClient characteristics varied by HCT model. Importantly, rural and urban mobile units reached more men, first-time testers, and clients who considered themselves to be at low risk for HIV. |
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