Changes in HIV risk behavior and seroincidence among clients presenting for repeat HIV counseling and testing in Moshi, Tanzania.
Abstract
While HIV counseling and testing (HCT) has been considered an HIV preventive measure
in Africa, data are limited describing behavior changes following HCT. This study
evaluated behavior changes and estimated HIV seroincidence rate among returning HCT
clients. Repeat and one-time testing clients receiving HCT services in Moshi, Tanzania
were identified. Information about sociodemographic characteristics, HIV-related behaviors
and testing reasons were collected, along with HIV serostatus. Six thousand seven
hundred and twenty-seven clients presented at least once for HCT; 1235 (18.4%) were
HIV seropositive, median age was 29.7 years and 3712 (55.3%) were women. 1382 repeat
and 4272 one-time testers were identified. Repeat testers were more likely to be male,
older, married, or widowed, and testing because of unfaithful partner or new sexual
partner. One-time testers were more likely to be students and testing due to illness.
At second test, repeat testers were more likely to report that partners had received
HIV testing, not have concurrent partners, not suspect partners have HIV, and have
partners who did not have other partners. Clients who intended to change behaviors
after the first test were more likely to report having changed behaviors by remaining
abstinent (OR 2.58; p<0.0001) or using condoms (OR 2.00; p=0.006) at the second test.
HIV seroincidence rate was 1.49 cases/100 person-years (PY). Clients presenting for
repeat HCT reported some reduction of risky behavior and improved knowledge of sexual
practices and HIV serostatus of their partners. Promoting behavior change through
HCT should continue to be a focus of HIV prevention efforts in sub-Saharan Africa.
Type
Journal articleSubject
AdolescentAdult
Aged
Aged, 80 and over
Confidentiality
Counseling
Female
HIV Seronegativity
HIV Seropositivity
Health Knowledge, Attitudes, Practice
Humans
Incidence
Male
Mass Screening
Middle Aged
Risk-Taking
Sexual Behavior
Sexual Partners
Tanzania
Young Adult
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https://hdl.handle.net/10161/13792Published Version (Please cite this version)
10.1080/09540121.2012.658751Publication Info
Fiorillo, Suzanne P; Landman, Keren Z; Tribble, Alison C; Mtalo, Antipas; Itemba,
Dafrosa K; Ostermann, Jan; ... Crump, John A (2012). Changes in HIV risk behavior and seroincidence among clients presenting for repeat
HIV counseling and testing in Moshi, Tanzania. AIDS Care, 24(10). pp. 1264-1271. 10.1080/09540121.2012.658751. Retrieved from https://hdl.handle.net/10161/13792.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
John Andrew Crump
Adjunct Professor in the Department of Medicine
I am based in northern Tanzania where I am Site Leader for Duke University’s
collaborative research program based at Kilimanjaro Christian Medical Centre and Director
of Tanzania Operations for the Duke Global Health Institute. I oversee the design
and implementation of research studies on infectious diseases, particularly febrile
illness, invasive bacterial disease, HIV-associated opportunistic infections, clinical
trials of antiretroviral therapy and prevention of mother-to-child tr
Jan Ostermann
Adjunct Associate Professor of Global Health
Nathan Maclyn Thielman
Professor of Medicine
Broadly, my research focuses on a range of clinical and social issues that affect
persons living with or at risk for HIV infection in resource-poor settings. In Tanzania,
our group is applying novel methods to optimize HIV testing uptake among high-risk
groups. We recently demonstrated that the Discrete Choice Experiment (DCE), a form
of stated preference survey research, is a robust tool for identifying (a) which characteristics
of HIV testing options are most preferred by different populati
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