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Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. Results In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %–90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %–97 %) and speaking to a community leader about CVCT (79 %–88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). Conclusions CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from more senior INLs and group presentations leveraged INAs’ one-on-one promotions. The INL/INA model was effective in promoting couples to seek joint HIV testing and counseling and may have broader application to other sub-Saharan African countries to sustainably increase CVCT uptake.

Human immuno-deficiency virus (HIV) counseling affirms that people exercise the right to know their HIV status, which opens the gateway to care, treatment, and support for a person in need. HIV counseling and testing uptake among sexually active males in Ethiopia is too low. Moreover, existing studies were not done at country level and the contributing factors were not well studied. Therefore, the aim of this study is to determine the status of uptake and identify its correlates using the 2016 Ethiopia Demographic and Health Survey. Data on 12,688 participants were utilized in this study. Descriptive statistics and multilevel logistic regression were used to summarize the data and investigate the associations between predictors and HIV counseling and testing uptake. The overall HIV voluntary counseling and testing uptake among sexually active men in Ethiopia was 45.69%; 95% CI [43.08%, 48.33%]. About 13% of the variation in the likelihood of being tested for HIV was due to the variation among the regions. On the other hand, age, religion, education, occupation, marital status, HIV knowledge, health insurance coverage, wealth status, risky sexual behavior, family planning discussion with health workers, owning a mobile, frequency of watching television, and listening to the radio were significantly associated with the uptake of HIV voluntary counseling and testing. HIV voluntary counseling and testing uptake in Ethiopia is still low and varies across the regions, which might hamper the ambitious plan of Ethiopia to end AIDS as a public health threat by 2030. Therefore, giving due consideration to scale up HIV knowledge to avoid risky sexual behavior, improving access to health insurance and media, and working on the significant modifiable sociodemographic determinants are worthy to boost HIV voluntary counselling and testing uptake, which is an integral component of the strategies to efficiently prevent and control HIV.

Context: Violence against women is a global phenomenon that cuts across all social and economic classes. Aims:This study was designed to measure the prevalence and correlates of domestic violence (DV) among women seeking services at a voluntary counseling and testing (VCT) center in Bangalore, India. Settings and Designs: A cross-sectional survey was conducted among women visiting an human immunodeficiency virus (HIV) VCT center in Bangalore, between September and November 2005. Materials and Methods:An interviewer-administered questionnaire was used to collect information about violence and other variables. Statistical Analysis Used:Univariable associations with DV were made using Pearson Chi-squared test for categorical variables and Student t-test or the Mann-Whitney test for continuous variables. Results:Forty-two percent of respondents reported DV, including physical abuse (29%), psychological abuse (69%) and sexual abuse (1%). Among the women who reported violence of any kind, 67% also reported that they were HIV seropositive. The most common reasons reported for DV included financial problems (38%), husband′s alcohol use (29%) and woman′s HIV status (18%). Older women (P < 0.001) and those with low income levels were the most likely to have experienced DV (P = 0.02). Other factors included husband′s education, HIV seropositivity and alcohol or tobacco use (P < 0.001). Conclusion: This study found DV levels comparable to other studies from around the world. The findings highlight the need for additional training among health care providers in VCT centers in screening for DV, detection of signs of physical abuse and provisions and referrals for women suffering from domestic partner violence.

Improving HIV screening in key populations is a crucial strategy to achieve the goal of eliminating AIDS in 2030. Social networking platforms can be used to recruit high risk-taking men who have sex with men (MSM) to promote the delivery of voluntary counseling and testing (VCT) as mobile HIV testing. Therefore, client recruitment and availability of mobile HIV testing through social networking platforms requires further evaluation. The aim of this study is to compare the effects of targeting high risk-taking MSM and HIV case finding between two mobile HIV testing recruitment approaches: through the traditional website-based approach and through social networking platforms. A comparative study design and propensity score matching was applied. The traditional VCT model, that is, the control group, recruited MSM through a website, and a trained research assistant visited the walk-in testing station at a gay village on Friday and Saturday nights. The social networking VCT model, the experimental group, recruited MSM from social networking platforms by periodically reloading into and conducting web-based discussions on dating apps and Facebook. The participants then referred to others in their social networks via a popular messenger app in Taiwan. The test was conducted at a designated time and place during weekdays by a trained research assistant. Across both modes of contact, before the mobile HIV testing, participants needed to provide demographic characteristics and respond to a questionnaire about HIV risk-taking behaviors. We recruited 831 MSM over 6 months, with a completion rate of 8.56% (616/7200) in the traditional VCT model and 20.71% (215/1038) in the social networking VCT model. After propensity score matching, there were 215 MSM in each group (mean age 29.97, SD 7.61 years). The social networking model was more likely to reach MSM with HIV risk-taking behaviors, that is, those seeking sexual activity through social media, having multiple sexual partners and unprotected anal intercourse, having experience of recreational drug use, and never having or not regularly having an HIV test, compared with the traditional model. HIV positive rates (incidence rate ratio 3.40, 95% CI 1.089-10.584; P=.03) and clinic referral rates (incidence rate ratio 0.03, 95% CI 0.001-0.585; P=.006) were significantly higher among those in the social networking VCT model than in the traditional VCT model. Through effective recruitment strategies on social networking platforms, the social networking VCT mode can be smoothly promoted, as compared with the traditional VCT model, to target high risk-taking MSM and increase testing outcomes.

Paid sex is associated with HIV and other sexually transmitted infections, which are highly prevalent in Sub-Saharan Africa (SSA). However, few data exist on this sexual practice among the general population in SSA, including the Democratic Republic of the Congo, where data on paid sex mainly comes from sex workers. In the DRC, most HIV Voluntary Counseling and Testing (VCT) centers do not discuss paid sex as a risk factor. Thus, we aimed to analyze the prevalence of paid sex, its associated factors and association with HIV among women and men attending HIV VCT at a reference hospital in Kinshasa. From 2016 to 2018, the Observational Kinshasa AIDS Initiative cohort analyzed the impact of HIV VCT on changes in HIV knowledge, attitudes, and sexual behaviors at follow-up. Participants aged 15–69 years were HIV tested and interviewed at baseline and at 6- and 12-month follow-ups. At baseline, participants were asked about their history of “ever” having had exchanged sex for money. At both follow-ups, the frequency of this practice was referred to as “the previous 6 months.” Descriptive, bivariate, and multivariate logistic regression analyses were carried out to evaluate the prevalence of paid sex, its associated factors, and the association between paid sex and HIV. Statistical analyses were performed with Stata 15.1. Among 797 participants at baseline, 10% of those sexually experienced reported having ever had paid sex (18% men and 4% women, p  < 0.001). At 6 and 12-month follow-ups, 5% and 2%, respectively. Paid sex was significantly and independently associated with being male (aOR = 2.7; 95% CI = 1.4–5.2), working or studying (aOR = 2.8; 95% CI = 1.5–5.0), daily newspaper reading (aOR = 4.4; 95% CI = 1.7–11.2); daily/weekly alcohol consumption (aOR = 3.3; 95% CI = 1.8–6.1), first sexual intercourse before age 15 years (aOR = 2.3; 95% CI = 1.1–5.0), multiple sexual partners (aOR = 4.1; 95% CI = 2.2–7.7), and extragenital sexual practices (aOR = 2.4; 95% CI = 1.3–4.4). A high religiosity (daily/weekly church attendance and praying) was inversely associated with paid sex (aOR = 0.1; 95% CI = 0.0–0.4). The high prevalence of paid sex among people attending HIV VCT in Kinshasa, associated with other sexual and consumption risk behaviors, highlights the need to include paid sex among the risk factors mentioned in HIV prevention counseling.

The effectiveness of HIV voluntary counseling and testing (VCT) in reducing HIV risk behaviors in developing countries was assessed using meta-analytic methods. A standardized protocol was used for searching, acquiring, and extracting study data and meta-analyzing the results. Seven studies met the inclusion criteria. VCT recipients were significantly less likely to engage in unprotected sex when compared to behaviors before receiving VCT, or as compared to participants who had not received VCT [OR 1.69; 95%CI 1.25–2.31]. VCT had no significant effect on the number of sex partners [OR 1.22; 95%CI 0.89–1.67]. While these findings provide only moderate evidence in support of VCT as an effective prevention strategy, neither do they negate the need to expand access to HIV testing and counseling services. Such expansion, however, must be accompanied by rigorous evaluation in order to test, refine and maximize the preventive benefits of learning one’s HIV infection status through HIV testing and counseling.

The epidemiology of human immunodeficiency virus (HIV) infection in Ethiopia varies with regions, study population, and time. Thus, timely information on HIV epidemiology is critical for the combat of the epidemic. In this study, we aim to update HIV prevalence and risk factors among voluntary counseling and testing (VCT) clients at the University of Gondar Teaching Hospital, Northwest Ethiopia. A total of 2,120 VCT clients' records from September 2007 to August 2010 were analyzed retrospectively. Bivariate logistic regression analysis was used to identify significant predictors. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. Statistical significance was set at P-value <0.05. Of 2,120 VCT clients, 363 (17.1%) were seropositive for HIV. A higher rate of HIV positivity was observed among female clients (20.4%) than that in male clients (14.0%) (OR 1.58, 95% CI 1.26-1.98, P=0.00). Widowed (95% CI 10.42-34.92, P=0.00), married (95% CI 3.42-5.94, P=0.00), divorced (95% CI 2.79-5.32, P=0.00), and illiterate (95% CI 2.33-5.47, P=0.00) clients were associated with HIV infection with the odds ratios of 19.07, 4.51, 3.85, and 3.57, respectively. Clients within the age category of 35-49 years (OR 5.03, 95% CI 3.56-7.12, P=0.00) and above the age of 50 years (OR 4.99, 95% CI 2.67-9.34, P=0.00) were more likely to be infected with HIV. HIV is still the major concern of public health in the Gondar area as evidenced by our data. Being female, widowed, married, illiterate, and older age were the identified risk factors for HIV infection. Thus, consideration of these factors in future intervention and clinical practice is recommended.

In recent years, China has seen a rapid rise in the HIV epidemic, especially among college students. However, the uptake of HIV testing was low. This study aimed to explore the factors influencing the acceptance of voluntary counseling and testing (VCT) among sexually active college students, in order to provide scientific evidence for the prevention and control of HIV infection on campus. A cross-sectional study was completed at 13 colleges in 11 cities by stratified cluster random sampling. We formulated a questionnaire to collect information on demographic characteristics, sexual behaviors, sexual attitudes, HIV-relevant knowledge, and HIV/AIDS interventions. The chi-square test was performed to compare composition ratios. Single-factor logistic regression and multivariate regression analyses were performed to determine the influencing factors. This study included 3873 college students with sexual experience, of whom 199 had received VCT, accounting for 5.14%. The results of the multivariate logistic regression analysis demonstrated that the participants who were age ≥ 22 (OR = 2.11, 95% CI: 1.36-3.29), had casual sex in the past year (OR = 1.75, 95% CI: 1.21-2.52), had received a lecture or health education class on HIV/AIDS at school (OR = 1.80, 95% CI: 1.07-3.02), had received school information on HIV testing (OR = 2.15, 95% CI: 1.32-3.50), and had received a school-based HIV risk self-assessment in the last year (OR = 3.47, 95% CI: 2.40-5.03) were inclined to receive VCT. The findings revealed that college students who had received health education about AIDS or acquired HIV testing information on campus were inclined to receive VCT, especially those who had engaged in high-risk sexual behaviors. Regarding HIV prevention among college students, it is recommended that health education related to AIDS be conducted regularly on campus and that HIV testing be promoted to increase the testing rate.

Background Voluntary Counselling and Testing (VCT) centres provide free and anonymous Human Immunodeficiency Virus (HIV) testing along with counselling services. They remove barriers to testing and lead to higher HIV awareness. The current healthcare system in Türkiye achieves high treatment rates in the continuum of care. However, the estimated diagnosis rates are far below the global targets, posing a significant challenge. This also creates an opportunity to intensify prevention efforts against the burden of the disease. Expanded VCT services is a suggested strategy for Türkiye, but research evaluating its effectiveness is lacking. Methods We developed a dynamic compartmental model with different testing sites as separate compartments, distinguishing VCT centres from others. Using the data from each VCT centre, we quantified the impact of this strategy through various scenarios. Results We found that under the assumption that the VCT strategy primarily serves high-risk populations, it could yield 50 to 74-fold more pay-off in terms of the number of cases prevented per additional test than other facilities. A two- and four-fold increase in both types of testing facilities (VCT and other) would reduce annual incidence in 2033 by 71% and 91%, respectively, while prevalence was estimated to be 34% and 51% lower compared to no action. Conclusions Our findings suggest that prioritizing VCT expansion is highly efficient strategy compared to other testing sites. Future research could focus on resource allocation, costs and benefits of the programs to ensure the optimal allocation of the resources to the most cost-effective public health strategies.

Voluntary counseling and testing (VCT) for couples (CVCT) is an important HIV-prevention effort in sub-Saharan Africa where a substantial proportion of HIV transmission occurs within stable partnerships. This study aimed to determine the acceptance and effectiveness of CVCT as compared to individual VCT (IVCT). 1,521 women attending three antenatal clinics in Dar es Salaam were randomized to receive IVCT during that visit or CVCT with their husbands at a subsequent visit. The proportion of women receiving test results in the CVCT arm was significantly lower than in the IVCT arm (39 vs. 71%). HIV prevalence overall was 10%. In a subgroup analysis of HIV-positive women, those who received CVCT were more likely to use preventive measures against transmission (90 vs. 60%) and to receive nevirapine for themselves (55 vs. 24%) and their infants (55 vs. 22%) as compared to women randomized to IVCT. Uptake of CVCT is low in the antenatal clinic setting. Community mobilization and couple-friendly clinics are needed to promote CVCT.