Advanced Search
MyIDEAS: Login to save this article or follow this journal

Strong effects of home-based voluntary HIV counselling and testing on acceptance and equity: A cluster randomised trial in Zambia

Contents:

Author Info

  • Fylkesnes, Knut
  • Sandøy, Ingvild Fossgard
  • Jürgensen, Marte
  • Chipimo, Peter J.
  • Mwangala, Sheila
  • Michelo, Charles
Registered author(s):

    Abstract

    Home-based voluntary HIV counselling and testing (HB-VCT) has been reported to have a high uptake, but it has not been rigorously evaluated. We designed a model for HB-VCT appropriate for wider scale-up, and investigated the acceptance of home-based counselling and testing, equity in uptake and negative life events with a cluster-randomized trial. Thirty six rural clusters in southern Zambia were pair-matched based on baseline data and randomly assigned to the intervention or the control arm. Both arms had access to standard HIV testing services. Adults in the intervention clusters were offered HB-VCT by local lay counsellors. Effects were first analysed among those participating in the baseline and post-intervention surveys and then as intention-to-treat analysis. The study was registered with www.controlled-trials.com, number ISRCTN53353725. A total of 836 and 858 adults were assigned to the intervention and control clusters, respectively. In the intervention arm, counselling was accepted by 85% and 66% were tested (n = 686). Among counselled respondents who were cohabiting with the partner, 62% were counselled together with the partner. At follow-up eight months later, the proportion of adults reporting to have been tested the year prior to follow-up was 82% in the intervention arm and 52% in the control arm (Relative Risk (RR) 1.6, 95% CI 1.4–1.8), whereas the RR was 1.7 (1.4–2.0) according to the intention-to-treat analysis. At baseline the likelihood of being tested was higher for women vs. men and for more educated people. At follow-up these differences were found only in the control communities. Measured negative life events following HIV testing were similar in both groups. In conclusion, this HB-VCT model was found to be feasible, with a very high acceptance and to have important equity effects. The high couple counselling acceptance suggests that the home-based approach has a particularly high HIV prevention potential.

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613001299
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 86 (2013)
    Issue (Month): C ()
    Pages: 9-16

    as in new window
    Handle: RePEc:eee:socmed:v:86:y:2013:i:c:p:9-16

    Contact details of provider:
    Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description

    Order Information:
    Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
    Web: http://www.elsevier.com/orderme/journalorderform.cws_home/315/journalorderform1/orderooc/id=654&ref=654_01_ooc_1&version=01

    Related research

    Keywords: Sub-Saharan Africa; Zambia; Cluster-randomized trial; HIV/AIDS; Voluntary counselling and testing (VCT); Home-based testing; Equity; Consent;

    References

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
    as in new window
    1. Elliot Marseille & James G. Kahn & Christian Pitter & Rebecca Bunnell & William Epalatai & Emmanuel Jawe & Willy Were & Jonathan Mermin, 2009. "The Cost Effectiveness of Home-Based Provision of Antiretroviral Therapy in Rural Uganda," Applied Health Economics and Health Policy, Springer Healthcare | Adis, vol. 7(4), pages 229-243.
    2. Angotti, Nicole & Bula, Agatha & Gaydosh, Lauren & Kimchi, Eitan Zeev & Thornton, Rebecca L. & Yeatman, Sara E., 2009. "Increasing the acceptability of HIV counseling and testing with three C's: Convenience, confidentiality and credibility," Social Science & Medicine, Elsevier, vol. 68(12), pages 2263-2270, June.
    3. Peter Glick & David Sahn, 2007. "Changes in HIV/AIDS knowledge and testing behavior in Africa: how much and for whom?," Journal of Population Economics, Springer, vol. 20(2), pages 383-422, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as in new window

    Cited by:
    1. Jürgensen, Marte & Sandøy, Ingvild F. & Michelo, Charles & Fylkesnes, Knut & Mwangala, Sheila & Blystad, Astrid, 2013. "The seven Cs of the high acceptability of home-based VCT: Results from a mixed methods approach in Zambia," Social Science & Medicine, Elsevier, vol. 97(C), pages 210-219.

    Lists

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    Statistics

    Access and download statistics

    Corrections

    When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:86:y:2013:i:c:p:9-16. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.