The proposed project is a multisite study of testing and counseling (T&C) for HIV, designed to investigate the factors that hinder or facilitate uptake in different settings. The uptake of T&C is key to the success of HIV treatment and prevention programs, and it is especially important to understand its determinants in view of current debates regarding the shift from stand-alone voluntary T&C to integrated routine services. The study makes systematic comparisons across four sites that differ in terms of the provision of T&C and the social context in which services are provided. The first phase of the analysis is carried out for each site separately, and investigates three sets of factors thought to influence the uptake of testing: the behaviors and motivations of users and non-users of services towards testing and disclosure;the provision of testing and counseling, including whether testing is client- or provider-initiated;and the implementation of practices related to confidentiality and consent. The second phase of the analysis consists of systematic comparisons across sites to identify the particular characteristics of programs and context that are associated with the uptake of testing and with positive responses among clients. Among the specific questions examined in comparative analyses are: the extent of the association of stigma with testing and disclosure;the influence of gender on testing and disclosure;the circumstances that shape practices related to informed consent and confidentiality;and the extent to which these practices influence clients'responses. The study is based on interviews with health providers, with clients of testing services, and with non- users (people who have not been tested), as well as on observations at study sites. Data will be collected at health facilities, including: stand-alone HIV testing and counseling facilities, facilities that provide care to people living with HIV, and facilities that provide HIV testing and counseling as part of providing other health services, such as antenatal care, care for tuberculosis, or for sexually transmitted infections. Analyses will combine statistical methods for quantifiable survey data, and qualitative methods for the textual data resulting from open-ended responses and observations.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
7R01HD053268-06
Application #
8309502
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Newcomer, Susan
Project Start
2006-09-30
Project End
2014-07-31
Budget Start
2011-08-01
Budget End
2014-07-31
Support Year
6
Fiscal Year
2010
Total Cost
$466,836
Indirect Cost
Name
American University of Beirut
Department
Type
DUNS #
071033294
City
Beirut
State
Country
Lebanon
Zip Code
11-02-36
Osborn, Michelle; Obermeyer, Carla Makhlouf (2016) Understanding client satisfaction with HIV testing and counseling services: a mixed-methods study in four African countries. AIDS Care 28:689-94
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Desclaux, Alice; Ky-Zerbo, Odette; Somé, Jean-François et al. (2014) Ethical considerations of providers and clients on HIV testing campaigns in Burkina Faso. BMC Int Health Hum Rights 14:27
Ky-Zerbo, Odette; Desclaux, Alice; Somé, Jean-François et al. (2014) [HIV/AIDS stigma in Africa: analysis of its forms and manifestations in Burkina Faso]. Sante Publique 26:375-84
Obermeyer, Carla Makhlouf; Verhulst, Cairn; Asmar, Khalil et al. (2014) Could you have said no? A mixed-methods investigation of consent to HIV tests in four African countries. J Int AIDS Soc 17:18898
Obermeyer, Carla Makhlouf; Neuman, Melissa; Hardon, Anita et al. (2013) Socio-economic determinants of HIV testing and counselling: a comparative study in four African countries. Trop Med Int Health 18:1110-1118
Neuman, Melissa; Obermeyer, Carla Makhlouf; MATCH Study Group (2013) Experiences of stigma, discrimination, care and support among people living with HIV: a four country study. AIDS Behav 17:1796-808
Wanyenze, Rhoda K; Kyaddondo, David; Kinsman, John et al. (2013) Client-provider interactions in provider-initiated and voluntary HIV counseling and testing services in Uganda. BMC Health Serv Res 13:423

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