TY - JOUR T1 - Behaviour change in clients of health centre-based voluntary HIV counselling and testing services in Kenya JF - Sexually Transmitted Infections JO - Sex Transm Infect SP - 541 LP - 546 DO - 10.1136/sti.2007.026732 VL - 83 IS - 7 AU - G Arthur AU - V Nduba AU - S Forsythe AU - R Mutemi AU - J Odhiambo AU - C Gilks Y1 - 2007/12/01 UR - http://sti.bmj.com/content/83/7/541.abstract N2 - 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. ER -