What Works for Women and Girls

In Uganda, through mobile and home-based VCT, the proportion of adults in Ugandawho have ever tested and received their HIV test results increased from 4% in 2000 to21% in 2006 (UNAIDS, 2009b). (Gray III) (counseling, HIV testing, Uganda)Surveys between 2005 and 2007 that assessed door-to-door VCT in a rural district inUganda found that the proportion of those who ever tested for HIV increased from20% to 63%. The proportion of people disclosing their serostatus increased from 72%to 81%. Among HIV-positive people who knew their serostatus, condom use at last sexincreased from 15% to 40% (Nuwaha et al., 2009). (Gray III) (HIV testing, condoms,disclosure, Uganda)A study nested in a cluster randomized trial in Uganda which compared home and clinicbasedmethods of HIV testing for family members of HIV-positive patients found thatthose reached at home were more likely to be tested for HIV. Of a total of 7,184 householdmembers, 3,974 (55% female) were reached at home. Assuming HIV prevalenceof 7%, 56% of HIV-positive household members were identified at home comparedto 27% in the clinic. HIV-positive patients were given free HIV testing vouchers andencouraged to invite members of their household to the clinic; or people were visited athome. Of 148 spouses of HIV-positive clients getting treated, 47% were HIV-negative(Lugada et al., 2009). (Gray V) (counseling, HIV testing, Uganda)A study in Kampala, Uganda from October 2005 to October 2007 indentified many otherwiseundiagnosed HIV-positive adults through home-based testing that was conductedif index clients had disclosed their serostatus to a household member, consented to thevisit, or requested counselor-assisted disclosure. Of 4,662 household members visited,90% agreed to VCT. Of the index clients, 75% were female. HIV prevalence was 19%among adults as compared to the Kampala average as per the 2004/2005 HIV/AIDSSero-Behavioral survey. Prevalence was higher among women (21%) as compared tomen (14%). Same day results were given using Determine for screening, Statpak forconfirmatory and Unigold for a tie-breaker (Nawavvu et al., 2008). (Abstract) (counseling,HIV testing, Uganda)Four hundred community mobilizers and 75 trained counselors going house to housein rural western Kenya increased counseling and testing. Using handheld computers,census data was recorded, whether household entry was allowed, consent for testing,age, sex, and HIV test results. Those consenting who were above age 12 were counseledand tested. The door to door census found 8,999 households containing 35,976people, of whom 52% were women. All but 13 allowed entry. Only 24% had previouslyhad an HIV test. Of 19,034 counseled, 18,229 had HIV tests. All who tested positivewere referred for care; those who tested HIV-negative were counseled on lowering riskbehaviors (Kimaiyo et al., 2008). (Abstract) (community outreach, counseling, HIV testing,Kenya)160 CHAPTER 6 HIV TESTING AND COUNSELING FOR WOMEN