222743 Cyber-VCT Pilot: Using solar-powered Internet access to incentivize HIV voluntary counseling and testing (VCT) and catalyze prevention capacity building within the remote island populations of Lake Victoria, Kenya

Monday, November 8, 2010

Charles Salmen, MPhil , School of Medicine, University of California San Francisco, San Francisco, CA
Kristopher Coontz, MPH , School of Medicine, University of California San Francisco, San Francisco, CA
Jason Nagata, MSc , School of Medicine, University of California San Francisco, San Francisco, CA
Daniel Zoughbie, MA , The Global-Micro-Clinic Project, San Francisco, CA
Craig Cohen, MD, MPH , OB/GYN and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Stan Ulijaseck, PhD , Institute of Social and Cultural Anthropology, Oxford University, Oxford, United Kingdom
Issues: Most of the island communities of Lake Victoria live without electricity or reliable health infrastructure. This population faces critical HIV/AIDS prevalence estimated at up to 30%. Unfortunately, HIV testing remains highly stigmatized. Description: The Cyber-VCT Pilot will encourage utilization of voluntary HIV testing services by providing access to solar-powered Internet as an excuse and incentive for participation in a unique “Post-Test Club” program. The Organic Health Response (OHR)—a local-global collaboration between Kenyan farmers, teachers, and health workers on Mfangano Island and US graduate students—has established a research consortium with Oxford University, Kenya Medical Research Institute, and University of California San Francisco to implement and evaluate this pilot. Using mixed epidemiologic and ethnographic methods, this pilot will evaluate the effectiveness of information technology in improving HIV testing utilization, while promoting locally-driven health, education, and environmental transformation. Lessons learned: OHR has constructed the “Cyber-VCT” facility featuring confidential VCT rooms, solar-powered computer lab with satellite Internet, radio studio, seminar rooms, and an open-air amphitheater. Extensive ethnographic fieldwork has revealed that enthusiasm for the Internet can encourage residents to overcome the stigma associated with stand-alone VCT centers. Internet access and training will be free for club members, based solely on bi-annual membership renewal through individualized sessions with certified VCT counselors. Recommendations: A planned cohort study will compare changes in HIV/AIDS literacy and stigma, social support, and spillover variables such as household food, income and water security between Club member families and randomly selected non-enrolled residents in adjacent communities.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify barriers to HIV/AIDS Voluntary Counseling and Test (VCT) in Western Kenya Describe strategies to incentivize VCT that simultaneously empower communities to address related health problems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee Organic Health Response's public health programs and am a co-investigator on the research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.