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HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: A Meta-analysis, 1990–2005

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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.

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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.

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Correspondence to Julie A. Denison.

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Denison, J.A., O’Reilly, K.R., Schmid, G.P. et al. HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: A Meta-analysis, 1990–2005. AIDS Behav 12, 363–373 (2008).

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