Background The creation of the only free anonymous HIV voluntary counselling and testing (VCT) center in Cotonou (named SIDAG) is an HIV prevention strategy that allows to reach those who decide, for themselves, to know their HIV status. Knowledge of the epidemiological profile and motivations of these volunteers will help tailoring services offered to them.
Objectives i) To describe practices at risk for HIV infection among the SIDAG's clientele ii) To analyse the motivations bringing these people for HIV screening; iii) To identify factors associated with HIV infection in this group. MethodsThis cross-sectional survey, carried out from April to June 2010, included all subjects attending SIDAG for HIV anonymous VCT who provided consent for participation. HIV testing was carried out immediately using an algorithm with two rapid tests (Determine and SD Bioline), and results were communicated on site to the participants before they leave.
Results 280 subjects participated in the study (149 men, 53% and 131 women, 47%). Their mean age was 28 years [range: 17–66 years]; 32% were college or university students, 53% had attained a higher educational level and 76% were single. 22% of the subjects had a history of STI. All subjects reported being heterosexual; 274 (98%) had sexual partners (regular partners: 73%; casual partners only: 25%). 27% always used condoms for casual sex. 13% of the men reported sex with sex workers. The main motivations for getting tested were the desire to know their HIV status: 43.6%; exposure to HIV through sexual contact: 20% (unprotected sex, condom failure, prolonged relation with HIV-infected partner); and peer pressure from family or friends: 11.2%. The HIV serology was positive in 6.8% of the 280 tested subjects. Factors associated with seropositivity were: a low education level (p<0.001), current or previous cohabitation with a sexual partner (p<0.01), lack of condom use (p<0.001) and motivation for testing because of clinical suspicion (p<0.001).
Conclusion Candidates for anonymous HIV VCT in Cotonou are mainly young patients concerned by the risk behaviours they had. Services like SIDAG should be decentralised to serve the greatest number.
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