HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: A Meta-analysis, 1990–2005
- 1.1k Downloads
The effectiveness of HIV voluntary counseling and testing (VCT) in reducing HIV risk behaviors in developing countries was assessed using meta-analytic methods. A standardized protocol was used for searching, acquiring, and extracting study data and meta-analyzing the results. Seven studies met the inclusion criteria. VCT recipients were significantly less likely to engage in unprotected sex when compared to behaviors before receiving VCT, or as compared to participants who had not received VCT [OR 1.69; 95%CI 1.25–2.31]. VCT had no significant effect on the number of sex partners [OR 1.22; 95%CI 0.89–1.67]. While these findings provide only moderate evidence in support of VCT as an effective prevention strategy, neither do they negate the need to expand access to HIV testing and counseling services. Such expansion, however, must be accompanied by rigorous evaluation in order to test, refine and maximize the preventive benefits of learning one’s HIV infection status through HIV testing and counseling.
KeywordsMeta-analysis Developing countries HIV voluntary counseling and testing Behavioral risk reduction
The authors wish to thank Krissy Brinsley, Carolyn Daher, Janean Martin, Elizabeth McCarthy, Amolo Okero, Amy Medley, Amanda Rosecrans, Andrea Ippel, Jennifer Gonyea, Sarah Kessler, and Devaki Nambiar for their coding work.
This research was supported by the World Health Organization, Department of HIV/AIDS, The US National Institute of Mental Health, grant number R01 MH071204, and The Horizons Program. The Horizons Program is funded by The US Agency for International Development under the terms of HRN-A-00-97-00012-00.
- Allen, S., Tice, J., Van de Perre, P., Serufilira, A., Hudes, E., Nsengumuremyi, F., Bogaerts, J., Lindan, C., & Hulley, S. (1992). Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa. British Medical Journal, 304(6842), 1605–1609.PubMedCrossRefGoogle Scholar
- CDC (2001). Revised guidelines for HIV counseling, testing and referral and revised recommendations for HIV screening of pregnant women. Morbidity and Mortality Weekly Report, 50(RR19), 1–58.Google Scholar
- Copper, H. M., & Hedges, L.V. (Eds.). (1994). The handbook of research synthesis. New York: Russell Sage Foundation.Google Scholar
- Farquhar, C., Kiarie, J. N., Richardson, B. A., Kabura, M. N., John, F. N., Nduati, R. W., Mbori-Ngacha, D. A., & John-Stewart, G. C. (2004). Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. Journal of Acquired Immune Deficiency Syndromes, 37(5), 1620–1626.PubMedCrossRefGoogle Scholar
- Kawichai, S., Beyrer, C., Khamboonruang, C., Celentano, D. D., Natpratan, C., Rungruengthanakit, K., & Nelson K. E. (2004). HIV incidence and risk behaviours after voluntary HIV counselling and testing (VCT) among adults aged 19–35 years living in peri-urban communities around Chiang Mai city in northern Thailand, 1999. AIDS Care, 16(1), 21–35.PubMedCrossRefGoogle Scholar
- Maman, S., Mbwambo, J. K., Hogan, N. M., Weiss, E., Kilonzo, G. P., & Sweat, M. D. (2003). High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: Reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS and Behavior, 7(4), 373–382.PubMedCrossRefGoogle Scholar
- UNAIDS (2000). Voluntary counselling and testing (VCT). UNAIDS Best Practice Collection. Technical Update, pp. 1–12.Google Scholar
- UNAIDS (2006). 2006 Report on the global AIDS epidemic. Geneva Switzerland: Joint United Nations Programme on HIV/AIDS.Google Scholar
- United Nations (UN) (2001). Resolution adopted by the General Assembly: S-26/2 declaration of commitment on HIV/AIDS. Twenty-sixth special session, A/RES/S-26–2.Google Scholar
- United Nations (UN) (2006). Resolution adopted by the General Assembly: 60/262 Political Declaration on HIV/AIDS (No. Sixtieth session. A/Res/60/262.): UN General Assembly.Google Scholar
- WHO (2006). Addressing violence against women in HIV testing and counselling: A meeting report. Geneva: WHO.Google Scholar
- WHO & UNAIDS. (2007). Guidance on provider-initiated HIV testing and counseling in health facilities. Geneva, Switzerland: WHO and UNAIDS.Google Scholar
- WHO, UNAIDS, & UNICEF (2007). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector. Progress Report, April 2007. Geneva, Switzerland: WHO, UNAIDS and UNICEF.Google Scholar
- World Bank (2005). Countries and Regions. Retrieved December 12, 2005 from http://www.worldbank.org/
- Xu, F., Kilmarx, P. H., Supawitkul, S., Manopaiboon, C., Yanpaisarn, S., Limpakarnjanarat, K., Chaikummao, S., Mock, P. A., Young, N. L., & Mastro, T. D. (2002). Incidence of HIV-1 infection and effects of clinic-based counseling on HIV preventive behaviors among married women in northern Thailand. Journal of Acquired Immune Deficiency Syndroms, 29(3), 284–288.Google Scholar