We request support to carry out a pilot study to ascertain the feasibility of a community-based voluntary HIV counseling and testing program (CBVCT) in commercial sex venues in Lima, Peru. This work follows on 10 years of experience conducting STD research in sex workers in Peru. The Peruvian government program offers clinic-based testing yet despite having strengthened capabilities to deliver services, there is a substantial group of individuals not served by this system. We will develop methods for working in these settings to deliver a rapid, high quality and confidential voluntary testing service addressing female sex workers (FSW) and their clients and for capturing relevant process and outcome indicators. Eight months of field-testing is planned after a 9-month field preparation phase. Following this pilot study we will prepare a grant proposal to formally evaluate of this intervention. Motivation for this work arises from a demonstrated efficacy of voluntary testing and counseling programs and the need to overcome barriers to clinic access in hard-to-reach populations with the goal of identifying individuals with early-stage HIV infection and motivate risk reduction behavior change.
