Barcelona 2013
Barcelona 2013
Abstract book - Abstract - 507
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International Committee
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Scientific Committee
Abstract #507  -  E-Posters English
  50.14: E-Posters English (Poster) on Sunday   in  Chaired by
  Presenting Author:   Dr Lucia Knight - Human Sciences Research Council, South Africa
  Additional Authors:  Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna  Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS,  
Preliminary findings from a home-based counselling and testing (HBCT) trial in rural South Africa are promising. The study, which provides point of care CD4 and referrals to treatment and care services, observes a 98% uptake of HBCT, with 30% first-time testers. Over 60% of those tested were not yet on anti-retroviral therapy (ART) and had a high CD4 counts (median CD4- 450 cells/µL). Despite these encouraging results as a new HIV counselling and testing approach, little is known about the acceptability of HBCT, particularly with regards to important ethical concerns including, the potential for lack of privacy and increased stigma and discrimination for vulnerable persons receiving the service. This paper offers a unique in-depth qualitative investigation into the acceptability and experience of HBCT in the South African context.
Method / Issue:
This paper presents the results of an on-going qualitative study to understand the experiences of a sample of participants who have been enrolled in HBCT (30 respondents), those who are HBCT providers (4) and service providers who receive referrals from HBCT (20). The aim was to use in-depth semi-structured interviews to assess the acceptability of the home-based service.
Results / Comments:
Preliminary findings suggest that those enrolled in and providing HBCT have an overwhelmingly positive perception of this service. Those who were tested welcomed the opportunity to receive a personal provision in the privacy and comfort of their own homes. Interestingly we found that the key concerns often leveled at HBCT providers around participants being identified as being part of the study and potentially victims of stigma and discrimination were, outweighed, for respondents, by the personal level of service they received. People felt that HBCT providers gave them adequate time and they felt able to ask questions, this was in contrast to the clinic where there was always someone else waiting to be dealt with and the provider was sticking to strict timelines that. The immediacy of getting test and CD4 results in one sitting without the waiting time and delays associated with the clinic was a major benefit of HBCT for participants. Those enrolled in the service felt empowered by the HIV test, knowing their CD4 count, getting correct referrals and the related detailed information they received and were able to ask for as part of HBCT. HBCT was also identified as an important factor in people?s decision to seek care as well as start and adhere to ART.
The qualitative results support the quantitative findings of the HBCT study and suggest that HBCT is highly acceptable to users. HBCT also has the potential to not only test those who may not have tested as part of voluntary services such as those who have higher CD4 count and may be asymptomatic. The fact that HBCT in this context has had such an overwhelmingly positive response and also positive implications in terms of referrals and linkages suggests that it may present an opportunity for further investigation and consideration as an important strategy to increase coverage of HIV testing and ART uptake.
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