Evidence-based services development in voluntary counseling and testing centers in Romania

Romania is known for its high proportion of children living with HIV/AIDS, many of whom were infected through unsafe blood transfusion practices during the communist period. According to the 1999 RHS, over 99% of the population was aware of HIV/AIDS, but less than 8% had ever been tested for HIV. JSI responded by collaborating with local authorities, healthcare professionals, and the Romanian Association Against AIDS (ARAS) to establish four USAID-funded VCT centers in three cities. An analysis of data collected via VCT client forms from these four centers from 1999-2006 sought to reveal patterns in client profiles over time such as the proportion of clients from vulnerable groups and factors contributing to adherence to a risk-reduction plan. Statistical methods used include logistic regression, frequency tables, and t-tests. This was the first cumulative analysis of this data since collection began in 1999. Many client characteristics changed over time with statistical significance such as mean age, motivation for testing, previous exposure to VCT services, HIV knowledge, and STI status. The regression analysis of factors contributing to adherence to a risk-reduction plan indicates, in some cases, that clients from vulnerable groups, clients with higher levels of counselor-assessed HIV knowledge, and clients who cite motivations for testing other than high-risk behavior were more likely to adhere to a risk reduction plan. These results can be used to create strategic plans for outreach activities, improve services, and inform recommendations for evidence-based VCT services development in Romania.