Targeting ever-married individuals with mobile HIV counseling and testing to reach high risk groups

Background: The USAID-funded Private Sector Program-Ethiopia (PSP-E) provided mobile HIV counseling and testing (MHCT) services in more than 40 towns of Ethiopia. MHCT targeted most at-risk populations to create access to and demand for HIV prevention, care and treatment services. Methods: Data was collected by nurse counselors using standardized forms. From July 2007 to December 2008, a total of 31,091 ever-married clients were tested. Data was entered using EPI Info and analyzed using SPSS-13. PSP-E used focused mobilization strategies, such as women and peer promoters and BCC materials to reach high risk groups with MHCT. Results: Out of 31,091 ever-married clients, 1,694 (5.5 %) females and 1,063 (3.4%) males tested HIV-positive, which was higher than non-married clients [female= 369 (3.9%), male= 572 (2.0%)]. The odds ratio for widowed, divorced, and separated is 2.84, 1.92 and 1.78 respectively. Ever-married women had a two times higher chance of HIV infection than males, AOR=1.93[1.64-2.27]. Ever-married clients with a history of HIV testing revealed a significant negative association with HIV infection [AOR=0.41; CI: 0.35-0.47]. Chance of getting infected with HIV is two times higher among ever-married clients with STI history.Conclusions: Mobilization strategies for MHCT should continue to focus on ever-married individuals since it is effective at reaching high risk groups for HIV. Specific outreach should be focused on ever-married females. Partner disclosure and referral during counseling should be strengthened. Integrating STI services with MHCT is also important to reduce HIV risk among ever-married individuals.