What Works for Women and Girls

A 2006 and still ongoing study until 2011 that randomized communities to either amultilevel intervention providing community-based HIV mobile VCT in 48 communitiesin Tanzania, Zimbabwe, South Africa and Thailand or clinic-based VCT found thatHIV testing uptake increase three-fold in the communities with mobile testing, with21,391 people tested. In the intervention communities, community mobilization andpost-test services of support groups for both HIV-positive and HIV-negative to maintainnegative status were instituted, counseling, training workshops, stigma reductionworkshops, and information sharing sessions as well as mobile VCT. In additional,outreach workers and volunteers were used to increase access to VCT and make awarenessof HIV status more acceptable in community settings (Khumalo-Sakutukwa et al.,2008). (Gray III) (counseling, HIV testing, support groups, community outreach, Tanzania,Zimbabwe, South Africa, Thailand)A study in Zambia from 1995 to 2000 found that community workers who promotedcouples counseling in their neighborhoods significantly increased the numbers ofcouples who tested jointly. Previously tested couples were trained for three days tobe community outreach workers: “Like you, I am married and have been tested withmy spouse.” Community workers emphasized the importance of testing togetherand explained that one person in a couple can be HIV-positive and the other can beHIV-negative. Services were confidential. Complex questions were referred to counselors.Once outreach by community workers was discontinued, couples VCT droppedby 90%, from 230 couples per month to 20 couples per month when promotion waslimited to mass media. Of the 8,500 cohabitating couples who sought HIV testing, 51%were concordant HIV-negative; 26% were concordant positive; and 23% were coupleswith one partner positive and the other partner negative. Each couple spoke privatelywith a counselor in deciding to test. Individual counseling was provided on request.Transport, childcare, lunch and counseling were provided whether couples elected totest or not (Chomba et al., 2008). (Gray III) (counseling, HIV testing, community outreach,couples, Zambia)A randomized controlled trial in Thailand found that mobile VCT offered at no costin community public settings along with entertainment and education increased VCTuptake. VCT uptake increased from 18 to 25 people per day. The median age of thoseaccessing VCT decreased from 38 to 35 years of age. Between February 2007 andDecember 2008, 6,996 people accessed VCT with 1.6% testing HIV-positive (Kawichaiet al., 2008). (Abstract) (counseling, HIV testing, Thailand)A six-week awareness campaign in six rural villages in Tanzania that was evaluated by arandomly selected pre-post household survey for 120 households and VCT monitoringdata found that mobile VCT resulted in the direct testing of 1,116 people, 54.5% male or6.7% of the total adult population in the villages, with a significant increase in communitymembers reporting having ever been tested for the first time (Churchman et al.,2008). (Abstract) (counseling, HIV testing, Tanzania)158 CHAPTER 6 HIV TESTING AND COUNSELING FOR WOMEN