RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP 541
OP 546
DO 10.1136/sti.2007.026732
VO 83
IS 7
A1 G Arthur
A1 V Nduba
A1 S Forsythe
A1 R Mutemi
A1 J Odhiambo
A1 C Gilks
YR 2007
UL http://sti.bmj.com/content/83/7/541.abstract
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.