Marseille 2007
Marseille 2007
Abstract book
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Abstract #286  -  Acceptability of a translated community-based HIV voluntary testing and counselling service from Kenya among UK African communities: a qualitative study.
Session:
  6.28: Posters A (Poster) on Monday   in  Chaired by
Authors:
  Presenting Author:   Dr Audrey Prost - MRC Social & Public Health Sciences Unit, United Kingdom
 
  Additional Authors:  Ms Winnie  Ssanyu-sseruma, Dr Miriam  Taegtmeyer, Dr Gilly  Arthur,  
Aim:
Approximately one third of Africans living with HIV in the UK are unaware of their status. Many test late, often at the onset of an AIDS-related illness. Innovative strategies are urgently needed to increase uptake of HIV voluntary counselling and testing (VCT) to ensure timely access to care and reductions in onward transmission. This study used qualitative research methods to assess the acceptability to UK African communities of translating a successful Kenyan model of community-based HIV VCT using and rapid HIV tests.
 
Method / Issue:
Five focus group discussions with a total of 36 participants from over 15 African countries were held between August 2006 and January 2007 in London. Participants included Black African men and women aged between 19 and 55: 12 were young people aged between 19 and 27, 10 were working in the HIV sector, and 10 were living with HIV. Participants were given a description of how the Kenyan VCT model would be translated for the UK (this involved a carefully marketed service using trained counsellors located in local community based African organisations offering rapid HIV testing) and were asked to explore acceptability by identifying opportunities and challenges in setting this service in the UK. Discussions were recorded and verbatim transcripts were analysed thematically using a Framework approach.
 
Results / Comments:
Participants identified several barriers to setting up the service. First, many felt that HIV-related stigma within the African community would deter clients. They highlighted that east African community-based VCT services are targeted at the general population rather than at discrete social groups, and suggested that targeting UK Africans could make communities more vulnerable to stigma and discrimination. Second, some felt that lack of confidentiality within the community and inadequate counsellor training could undermine the service. However, a number of facilitators were also identified. Participants thought that: (1) conducting social marketing in African venues would draw clients to VCT centres; (2) placing mobile VCT clinics in areas with large African communities should be explored; (3) community-based organisations could be resources for social marketing as well as potential testing sites; (4) people living with HIV should be involved in counselling and managing VCT services, as this would reassure clients about confidentiality and professionalism.
 
Discussion:
Providing acceptable voluntary HIV testing services is key to promoting serostatus awareness and reducing the proportion of undiagnosed HUV infection among UK African communities. As articulated by participants in this study, the success of community-based VCT hinges upon community buy-in. VCT services should be community-owned, encompass mobilisation and stigma reduction interventions, and involve people living with HIV. The experience of VCT services from east Africa can be utilised to create innovative testing interventions in the UK: south-to-north translation is an unexplored yet promising opportunity for HIV prevention.
 
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