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Behaviour change in clients of health centre based voluntary HIV counselling and testing (VCT) services in Kenya
  1. Gilly Arthur (gilly.arthur{at}camdenpct.nhs.uk)
  1. Mortimer Market Centre and University College London, United Kingdom
    1. Videlis Nduba, Dr (vnduba{at}ke.cdc.gov)
    1. Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Kenya
      1. Steven Forsythe (steven.forsythe{at}gmail.com)
      1. Directorate of Health Management and Leadership, INSP, Mexico
        1. Roselyn Mutemi-Wangahu (rmutemi{at}unicef.org)
        1. United Nations Childrens Fund, Kenya
          1. Joseph Odhiambo (jodhiambo{at}ke.cdc.gov)
          1. Centre for Respiratory Diseases, Kenya Medical Research Institute, Kenya
            1. Charles Franklin Gilks (gilksc{at}who.int)
            1. Imperial College, London, United Kingdom

              Abstract

              Objective: To explore behaviour change, baseline risk behaviour, perception of risk, HIV disclosure and life events in health centre based Voluntary Counselling and Testing (VCT) clients.

              Design and setting: Single-arm prospective cohort with before-after design at three (one urban and two rural) government health centres, study duration 2 years, 1999-2001.

              Subjects: Consecutive eligible adult clients.

              Main Outcome Measures: Numbers of sexual partners, partner type, condom use, reported STI symptoms, HIV disclosure and life events.

              Results: High rates of enrolment and follow-up provided a demographically representative sample of 401 clients with mean time to follow-up of 7.4 months. Baseline indicators showed clients were higher risk than the general population, but reported a poor perception of risk. Clients with multiple partners showed significant reduction of sexual partners at follow-up (16% to 6%) p<0.001) and numbers reporting STI symptoms decreased significantly too (from 40% to 15%) p<0.001). Condom use improved from a low baseline. Low rates of disclosure (55%) were reported by HIV positive clients. Overall, no changes in rates of life events were seen.

              Conclusion: This study suggests that significant prevention gains can be recorded in clients receiving health centre based VCT services in Africa. Prevention issues should be considered when refining counseling and testing policies for expanding treatment programmes.

              • HIV/AIDS
              • developing countries
              • primary health care
              • sexual behaviour
              • voluntary counseling and testing

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