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Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa

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  • Tonderai Mabuto
  • Mary H Latka
  • Bulelani Kuwane
  • Gavin J Churchyard
  • Salome Charalambous
  • Christopher J Hoffmann

Abstract

Background: HIV Counseling and Testing (HCT) is the point-of-entry for pathways of HIV care and prevention. However, HCT is not reaching many who are HIV infected and this may be related to the HCT provision model. We describe HCT utilization and HIV diagnosis using four models of HCT delivery: clinic-based, urban mobile, rural mobile, and stand-alone. Methods: Using cross-sectional data from routine HCT provided in South Africa, we described client characteristics and HIV test results from information collected during service delivery between January 2009 and June 2012. Results: 118,358 clients received services at clinic-based units, 18,597; stand-alone, 28,937; urban mobile, 38,840; and rural mobile, 31,984. By unit, clients were similar in terms of median age (range 28–31), but differed in sex distribution, employment status, prior testing, and perceived HIV risk. Urban mobile units had the highest proportion of male clients (52%). Rural mobile units reached the highest proportion of clients with no prior HCT (61%) and reporting no perceived HIV risk (64%). Overall, 10,862 clients (9.3%) tested HIV-positive. Conclusions: Client characteristics varied by HCT model. Importantly, rural and urban mobile units reached more men, first-time testers, and clients who considered themselves to be at low risk for HIV.

Suggested Citation

  • Tonderai Mabuto & Mary H Latka & Bulelani Kuwane & Gavin J Churchyard & Salome Charalambous & Christopher J Hoffmann, 2014. "Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-7, July.
    • Handle: RePEc:plo:pone00:0102267
    DOI: 10.1371/journal.pone.0102267
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    References listed on IDEAS

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    1. Elizabeth L Corbett & Ethel Dauya & Ronnie Matambo & Yin Bun Cheung & Beauty Makamure & Mary T Bassett & Steven Chandiwana & Shungu Munyati & Peter R Mason & Anthony E Butterworth & Peter Godfrey-Faus, 2006. "Uptake of Workplace HIV Counselling and Testing: A Cluster-Randomised Trial in Zimbabwe," PLOS Medicine, Public Library of Science, vol. 3(7), pages 1-1, July.
    2. Ingrid V Bassett & Darshini Govindasamy & Alison S Erlwanger & Emily P Hyle & Katharina Kranzer & Nienke van Schaik & Farzad Noubary & A David Paltiel & Robin Wood & Rochelle P Walensky & Elena Losina, 2014. "Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-11, January.
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    Cited by:

    1. Vaz, Melita & Kadyan, Nisha & Chalil, Sumitha & Prasad, Turlapati L.N. & Singh, Aman Kumar, 2016. "Looking for sufficient change: Evaluation of counsellor training for STI syndromic management in India," Evaluation and Program Planning, Elsevier, vol. 58(C), pages 141-151.
    2. Brooke E Nichols & Hannelore M Götz & Eric C M van Gorp & Annelies Verbon & Casper Rokx & Charles A B Boucher & David A M C van de Vijver, 2015. "Partner Notification for Reduction of HIV-1 Transmission and Related Costs among Men Who Have Sex with Men: A Mathematical Modeling Study," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-15, November.

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