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Health services research
Comparison of users of an HIV/syphilis screening community-based mobile van and traditional voluntary counselling and testing sites in Guatemala
  1. Maria Lahuerta1,2,
  2. Meritxell Sabidó1,3,4,
  3. Federica Giardina1,3,
  4. Gabriela Hernández5,
  5. Juan Fernando Palacios6,
  6. Rudy Ortiz5,
  7. Victor Hugo Fernández5,
  8. Jordi Casabona1,3,7,8,
  9. for the UALE project
  1. 1Fundació Sida i Societat, Barcelona, Catalonia, Spain
  2. 2International Center for AIDS Care and Treatment Programs, Columbia University-Mailman School of Public Health, New York, USA
  3. 3CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  4. 4PhD Programme in Public Health and Methodology of Biomedical Research, Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
  5. 5Fundació Sida i Societat, Escuintla, Guatemala
  6. 6Programa Nacional Prevención y Control de ITS, VIH y Sida. Ministerio de Salud Pública y Asistencia Social de Guatemala
  7. 7Centre d'Estudis Epidemiològics sobre les ITS/HIV/SIDA de Catalunya (CEEISCAT), Institut Català d'Oncologia/Departament de Salut, Generalitat de Catalunya, Badalona, Catalonia, Spain
  8. 8Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Jordi Casabona, Centre d'Estudis Epidemiològics sobre les ITS/HIV/SIDA de Catalunya (CEEISCAT), Institut Català d'Oncologia/Departament de Salut, Generalitat de Catalunya, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Catalonia, Spain; jcb.ceescat.germanstrias{at}gencat.net

Abstract

Objectives The use of a mobile van (MV) for screening for HIV and other sexually transmitted infections (STIs) is effective at reaching at-risk populations. The aim of this study was to compare behaviour characteristics and HIV and syphilis prevalence between subjects tested at a MV offering voluntary counselling and testing and those tested at three STI clinics in Guatemala.

Methods Over 28 months, female sex workers (FSWs), men who have sex with men/transgenders (MSM/TG), and people not reporting being a member of a risk group (NR) were offered HIV and syphilis rapid tests and interviewed about their sociodemographic and risk behaviour.

Results 2874 subjects were tested (MV, 1336 (46%); clinics, 1538 (54%)). The MV screened 73% of FSWs and 73% of the MSM/TG, and detected 19% of HIV and 69% of syphilis cases. HIV prevalence was significantly higher (p<0.001) at the STI clinics than at the MV for both NR and MSM/TG groups (NR, 7% vs 1%; MSM/TG, 8% vs 1%, respectively). A significantly higher proportion of MSM/TG screened at the STI clinic reported having had a prior HIV test (MV, 21%; clinics, 41%; p<0.001), whereas more FSWs tested in the MV reported having multiple partners and using condoms during their last sexual intercourse.

Conclusions The higher prevalence of HIV and syphilis at the STI clinics suggests that they successfully identified high-risk subjects. In particular, the NR group showed higher than expected HIV and syphilis prevalence. Innovative approaches such as the use of a MV helped to increase access to other hard-to-reach groups such as MSM/TG and FSWs.

  • Mobile van
  • Guatemala
  • HIV
  • syphilis
  • rapid tests
  • outreach services
  • STD clinic
  • testing

https://doi.org/10.1136/sti.2010.043067

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    Footnotes

    • The full list involved in the UALE project are listed in the Appendix at the end of this paper.

    • Funding The project was supported by the Catalan Agency for Cooperation Development, the Spanish Agency for International Development Cooperation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Fundació Sida i Societat. The funding agency had no role in the design, conduct, or performance of the study, the analysis or reporting of the data, or the preparation, review, or acceptance of the article.

    • Competing interests None.

    • Ethics approval This study was included in the general IRB of the UALE project, which was approved by the Hospital Germans Trias i Pujol ethics review committee, and had the support of the Guatemalan Ministry of Health and the Escuintla Department of Health.

    • Provenance and peer review Not commissioned; externally peer reviewed.