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HIV voluntary counselling and testing for African communities in London: learning from experiences in Kenya
  1. A Prost1,2,
  2. W S Sseruma2,
  3. I Fakoya2,
  4. G Arthur2,
  5. M Taegtmeyer3,
  6. A Njeri4,
  7. A Fakoya5,
  8. J Imrie2
  1. 1MRC Social & Public Health Sciences Unit, Glasgow, Scotland, UK
  2. 2Centre for Sexual health & HIV Research, Royal Free and University College London Medical School, London, UK
  3. 3Liverpool School of Tropical Medicine, Liverpool, UK
  4. 4Liverpool VCT Care & Treatment, Nairobi, Kenya
  5. 5Newham General Hospital, London, UK
  1. Correspondence to:
 Dr A Prost
 Medical Research Council Social & Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, Scotland, UK; Centre for Sexual Health & HIV Research, Mortimer Market Centre, Off Capper Street, London WC1E 6JB, UK; aprost{at}gum.ucl.ac.uk

Abstract

Objectives: To explore the feasibility and acceptability of translating a successful voluntary counselling and testing (VCT) service model from Kenya to African communities in London.

Methods: Qualitative study with focus group discussions and a structured workshop with key informants. Five focus group discussions were conducted in London with 42 participants from 14 African countries between August 2006 and January 2007. A workshop was held with 28 key informants. Transcripts from the group discussions and workshop were analysed for recurrent themes.

Results: Participants indicated that a community-based HIV VCT service would be acceptable to African communities in London, but also identified barriers to uptake: HIV-related stigma, concerns about confidentiality, and doubts about the ability of community-based services to maintain professional standards of care. Workshop participants highlighted three key requirements to ensure feasibility: (a) efficient referrals to sexual health services for the newly diagnosed; (b) a locally appropriate testing algorithm and quality assurance scheme; (c) a training programme for VCT counsellors.

Conclusions: Offering community-based VCT with rapid HIV tests appears feasible within a UK context and acceptable to African communities in London, provided that clients’ confidentiality is ensured and appropriate support is given to the newly diagnosed. However, the persistence of concerns related to HIV-related stigma among African communities suggests that routine opt-out testing in healthcare settings may also constitute an effective approach to reducing the proportion of late diagnoses in this group. HIV service models and programmes from Africa constitute a valuable knowledge base for innovative interventions in other settings, including developed countries.

  • CBO, community-based organisation
  • LVCT, Liverpool VCT, Care and Treatment
  • VCT, voluntary counselling and testing

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Footnotes

  • Published Online First 2 October 2007

  • Contributors

    JI and MT had the original idea for this study. All authors contributed to planning the data collection and organising the workshop. WSS and AP carried out the focus group discussions. WSS, AP and IF collected and analysed the data. AP wrote the first draft of the paper and all authors contributed to further revisions.

  • Funding: By the Clinical Research and Development Committee at University College Hospital, London. AP is funded by an MRC Career Development Fellowship.

  • Competing interests: None declared.

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