Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110962

Dvora Joseph, MPH, Shannon England, MPH, and Kerry Richter, PHD. AIDSMark, Population Services International, 1120 19th St Nw Ste 600, Washington, DC 20036, 202-572-4645, djoseph@psi.org

Background: Voluntary counseling & testing (VCT) is a proven HIV prevention intervention and an essential gateway for HIV-care and support services. This study presents multi-country data on the motivations for and barriers to seeking VCT drawn from social marketing (SM) programs. It also examines the effectiveness of strategies that SM programs have used for effective behavior change communication (BCC).

Methods: Population Services International (PSI) implements VCT programs in nineteen countries in Africa and Asia: including Zimbabwe, Zambia, Uganda, India and Kenya. Qualitative research examines motivations and perceived barriers to VCT to guide the development of effective BCC campaigns. Population-based surveys use multivariate analysis to investigate public perceptions and use of VCT services over time.Clinic-based data from VCT clients provide sources of information and important reasons for seeking VCT.

Results: Stigma, fear of a HIV+ result, lack of treatment options and concerns about confidentiality are still major barriers to seeking VCT in all countries studied. However, multi-round population-based surveys from Zambia and Zimbabwe, have shown that mass-media BCC campaigns focusing on perceived benefits and importance of VCT significantly decreased stigma around VCT and fear of a HIV+ result over time. Motivations for seeking VCT services include relief from anxiety about risky sexual behavior or partner's behavior, and sickness/death of a partner. Multivariate analysis shows that using positive messages to target high-risk groups (men with multiple partners, clients of sex workers, sexually active youth, and couples) is an effective means of promoting VCT in high prevalence settings. VCT client intake data from these programs show that SM campaigns using mass-media are a key source of information for those seeking VCT services. Use of inter-personal communication (IPC) techniques has been effective in targeting high-risk clients of sex workers including truckers and MSM.

Conclusions: Social marketing of VCT using mass media and IPC techniques focusing on the positive benefits and importance of VCT are an effective means of promoting VCT and decreasing stigma around HIV-testing in high-prevalence settings. However, more analysis needs to be done to assess the best way to promote and deliver cost effective VCT services to high-risk groups in lower prevalence settings.

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