PT - JOURNAL ARTICLE AU - Arthur, G AU - Nduba, V AU - Forsythe, S AU - Mutemi, R AU - Odhiambo, J AU - Gilks, C TI - Behaviour change in clients of health centre-based voluntary HIV counselling and testing services in Kenya AID - 10.1136/sti.2007.026732 DP - 2007 Dec 01 TA - Sexually Transmitted Infections PG - 541--546 VI - 83 IP - 7 4099 - http://sti.bmj.com/content/83/7/541.short 4100 - http://sti.bmj.com/content/83/7/541.full SO - Sex Transm Infect2007 Dec 01; 83 AB - 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 in Kenya; study duration 2 years, 1999–2001. Subjects: Consecutive eligible adult clients. Main outcome measures: Numbers of sexual partners, partner type, condom use, reported symptoms of sexually transmitted infection, 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 7.5 months. Baseline indicators showed that clients were at higher risk than the general population, but reported a poor perception of risk. Clients with multiple partners showed a significant reduction of sexual partners at follow-up (16% to 6%; p<0.001), and numbers reporting symptoms of sexually transmitted infection decreased significantly also (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 counselling and testing policies for expanding treatment programmes.