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Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries
Virginia A Fonner1, Julie Denison, Caitlin E Kennedy
1Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. vtedrow@jhsph.edu.
The Cochrane Database of Systematic Reviews
|September 14, 2012
Summary
Voluntary counseling and testing (VCT) effectively reduces HIV risk behaviors, particularly among HIV-positive individuals. Further research is needed to optimize VCT strategies for maximum impact on behavior change and uptake.
Area of Science:
- Public Health
- Epidemiology
- Behavioral Science
Background:
- Voluntary counseling and testing (VCT) is crucial for HIV prevention, care, and treatment.
- Various VCT modalities, including clinic-, mobile-, and home-based, are utilized globally.
- This review synthesizes evidence on VCT's impact on HIV risk behaviors in low- and middle-income countries.
Purpose of the Study:
- To systematically review the efficacy of VCT in modifying HIV-related risk behaviors.
- To assess VCT's effectiveness across diverse populations in developing countries.
Main Methods:
- Searched five electronic databases (PubMed, EMBASE, PsycINFO, Sociological Abstracts, CINAHL) and hand-searched key journals.
- Included studies published between 1990-2010 in low- or middle-income countries, involving client-initiated VCT with pre/post or multi-arm designs.
- Extracted data on behavioral, psychological, biological, or social HIV-related outcomes; meta-analyzed comparable outcomes like condom use and number of sex partners.
Main Results:
- Analyzed 17 eligible studies (8 for meta-analysis), with most offering clinic-based VCT.
- VCT significantly reduced the odds of reporting an increased number of sexual partners (OR=0.69), particularly for HIV-positive individuals.
- Condom use showed a significant increase among HIV-positive participants receiving VCT (OR=3.24).
Conclusions:
- Findings support VCT as an effective HIV prevention strategy by altering sexual risk behaviors.
- Further research is essential to identify optimal VCT modalities and counseling strategies for behavior change and uptake.
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